A double-blind controlled trial of salmon calcitonin in pain due to malignancy

Thirty-two patients with established malignancy and associated pain participated in a randomised double-blind controlled trial. They received salmon calcitonin SC 200 UI or matching placebo 6-hourly for 48 h and were assessed by using a combination of a 20-point visual analogue scale (VAS), a 4-point physician's global pain scale, and ranking of the co-administered analgesics into 20 grades of potency. Twenty-five patients (13 calcitonin, 12 placebo) were evaluated. Seven patients (4 calcitonin, 3 placebo) were excluded either because the initial pain score was less than or equal to 5 on the VAS, or because there were insufficient data (due to death occurring within the first week of the study or, in one patient, blindness preventing completion of the VAS). One week after commencing therapy there was improvement or marked improvement of pain in significantly more patients in the calcitonin group (5/13) than in the placebo group (0/12) (Fisher's exact two-tailed probability test, P = 0.0484). At the end of the second week three patients in the calcitonin group were still showing marked improvement.