Calcitonin for prevention and treatment of postmenopausal osteoporosis

Prolonged calcitonin administration (intramuscular, subcutaneous, or intranasal) can prevent postmenopausal trabecular bone loss. Nasal administration constitutes a particularly attractive option for women who cannot tolerate or benefit from estrogen replacement therapy. The optimal schedule of administration still has to be precised, but 100 U/day of nasal calcitonin, combined with calcium supplements, can currently be recommended. Interrupted regimens are maybe favourable. Calcitonin can also prevent further bone loss in established osteoporosis particularly if bone turnover is increased. The anti-fracture efficacy of calcitonin is suggested by different types of studies but has not been formally demonstrated. Lastly, its analgesic efficacy in cases of painful vertebral compression fractures has been demonstrated in controlled studies.