[Calcitonin nasal spray for Paget's disease of the bone]

3 patients with prolonged, diffuse, bone pain due to Paget's disease were treated with intranasal salmon calcitonin, 200-400 U/d for 12 months. Within the first 3 months, in all 3 bone turnover decreased 31-35% (as assessed by serum alkaline phosphatase activity and urinary hydroxyproline/creatinine ratio). After 1 year of nasal calcitonin the reduction in serum alkaline phosphatase was 24%, and in urinary hydroxyproline 10%. In addition, pain and functional impairment markedly improved during the year. It is concluded that daily nasal calcitonin spray is well tolerated and effective initial treatment for Paget's disease of the bone.