[en] In the mid-1980s, calcitonin was used as a potential treatment for postmenopausal osteoporosis. However, after the results obtained in a pivotal study assessing the antifracture efficacy of the drug showed an absence of reduction in nonvertebral fractures, calcitonin has almost completely disappeared from the osteoporosis armomentarium. The development of a new ‘high-tech’ oral formulation of salmon calcitonin and the demonstration, in several in vitro and in vivo models of osteoarthritis, that this drug could exert beneficial effects on the chondrocytes and on the development of experimental osteoarthritis has generated some interest in this old molecule. However, at this stage, results from clinical trials remain inconclusive and caution should be exerted before considering oral calcitonin as a breakthrough in the management of osteoarthritis.
Disciplines :
General & internal medicine
Author, co-author :
Reginster, Jean-Yves ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Neuprez, Audrey ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Hiligsmann, Mickaël ; Université de Liège - ULiège > Département des sciences de la santé publique > Département des sciences de la santé publique
Bruyère, Olivier ; Université de Liège - ULiège > Département des sciences de la santé publique > Santé publique, Epidémiologie et Economie de la santé
Language :
English
Title :
Oral calcitonin in the management of osteoarthritis: hope or fantasy ?
Goldring SR, Goldring MB: Clinical aspects, pathology and pathophysiology of osteoarthritis. J. Musculoskelet. Neuronal Interact. 6, 376-378 (2006).
Martel-Pelletier J, Lajeunesse D, Fahmi H, Tardif G, Pelletier JP: New thoughts on the pathophysiology of osteoarthritis: one more step toward new therapeutic targets. Curr. Rheumatol. Rep. 8, 30-36 (2006).
Garstang SV, Stitik TP: Osteoarthritis: epidemiology, risk factors, and pathophysiology. Am. J. Phys. Med. Rehabil. 85, S2-S11 (2006).
Arden N, Nevitt MC: Osteoarthritis: epidemiology. Best Pract. Res. Clin. Rheumatol. 20, 3-25 (2006).
Jinks C, Jordan K, Croft P: Osteoarthritis as a public health problem: the impact of developing knee pain on physical function in adults living in the community: (KNEST 3). Rheumatology (Oxford) 46, 877-881 (2007).
Bruyere O, Burlet N, Delmas PD, Rizzoli R, Cooper C, Reginster JY: Evaluation of symptomatic slow-acting drugs in osteoarthritis using the GRADE system. BMC Musculoskelet. Disord. 9, 165-174 (2008).
Reginster JY: The efficacy of glucosamine sulfate in osteoarthritis: financial and nonfinancial conflict of interest. Arthritis Rheum. 56, 2105-2110 (2007).
Bruyere O, Reginster JY: Glucosamine and chondroitin sulfate as therapeutic agents for knee and hip osteoarthritis. Drugs Aging 24, 573-580 (2007).
Brandt KD, Mazzuca SA: Lessons learned from nine clinical trials of disease-modifying osteoarthritis drugs. Arthritis Rheum. 52, 3349-3359 (2005).
Reginster JY: Calcitonin for prevention and treatment of osteoporosis. Am. J. Med. 95, S44-S47 (1993).
Buclin T, Cosma Rochat M, Burckhardt P, Azria M, Attinger M: Bioavailability and biological efficacy of a new oral formulation of salmon calcitonin in healthy volunteers. J. Bone Miner. Res. 17, 1478-1485 (2002).
Reginster JY, Jupsin I, Deroisy R, Biquet I, Franchimont N, Franchimont P: Prevention of postmenopausal bone loss by rectal calcitonin. Calcif. Tissue Int. 56, 539-542 (1995).
Manicourt DH, Devogelaer JP, Azria M, Silverman S: Rational for the potential use of calcitonin in osteoarthritis. J. Musculoskelet. Neuronal Interact. 5, 285-293 (2005).
Tanko LB, Bagger YZ, Alexandersen P et al.: Safety and efficacy of a novel salmon calcitonin (sCT) technology-based oral formulation in healthy postmenopausal women: acute and 3-month effects on biomarkers of bone turnover. J. Bone Miner. Res. 19, 1531-1538 (2004).
Franchimont P, Bassleer C, Henrotin Y, Gysen P, Bassleer R: Effects of human and salmon calcitonin on human articular chondrocytes cultivated in clusters. J. Clin. Endocrinol. Metab. 69, 259-266 (1989).
Hellio MP, Peschard MJ, Cohen C, Richard M, Vignon E: Calcitonin inhibits phospholipase A2 and collagenase activity of human osteoarthritic chondrocytes. Osteoarthr. Cartil. 5, 121-128 (1997).
Sondergaard BC, Wulf H, Henriksen K et al.: Calcitonin directly attenuates collagen type II degradation by inhibition of matrix metalloproteinase expression and activity in articular chondrocytes. Osteoarthr. Cartil. 14, 759-768 (2006).
Karsdal MA, Tanko LB, Riis BJ et al.: Calcitonin is involved in cartilage homeostasis: is calcitonin a treatment for OA? Osteoarthr. Cartil. 14, 617-624 (2006).
Lin Z, Pavlos NJ, Cake MA et al.: Evidence that human cartilage and chondrocytes do not express caclitonin receptor. Osteoporos. Int. 16, 450-457 (2008).
Behets C, Williams JM, Chappard D, Devogelaer JP, Manicourrt DH: Effects of calcitonin on subchondral trabecular bone changes and on osteoarthritis cartilage lesions after acute anterior cruciate ligament deficiency. J. Bone Miner. Res. 19, 1821-1826 (2004).
Manicourt DH, Altman RD, Williams JM et al.: Treatment with calcitonin suppresses the responses of bone, cartilage, and synovium in the early stages of canine experimental osteoarthritis and significantly reduces the severity of the cartilage lesions. Arthritis Rheum. 42, 1159-1167 (1999).
El Hajjaji H, Williams JM, Devogelaer JP, Lenz ME, Thonar EJ, Manicourt DH: Treatment with calcitonin prevents the net loss of collagen, hyaluronan and proteoglycan aggregates from cartilage in the early stages of canine experimental osteoarthritis. Osteoarthr. Cartil. 12, 904-911 (2004).
Papaioannou NA, Triantafillopoulos IK, Khaldi L, Krallis N, Galanos A, Lyritis GP: Effect of calcitonin in early and late stages of experimentally induced osteoarthritis. A histomorphometric study. Osteoarthr. Cartil. 15, 386-395 (2007).
Sondergaard BC, Oestergaard S, Christiansen C, Tanko LB, Karsdal MA: The effect of oral calcitonin on cartilage turnover and surface erosion in an ovariectomized rat model. Arthritis Rheum. 56, 2674-2678 (2007).
Badurski J, Jeziernicka E, Naruszewicz K, Racewicz A: Comparative analysis of three treatment regimens for treating gonarthritis with calcitonin, naproxen and flavonoids based on EULAR criteria and visual analogue scale (VAS). Pol. Tyg. Lek. 50, 37-40 (1995).
Bagger YZ, Tanko LB, Alexandersen P et al.: Oral salmon calcitonin induced suppression of urinary collagen type II degradation in postmenopausal women: a new potential treatment of osteoarthritis. Bone 37, 425-430 (2005).
Manicourt DH, Azria M, Mindeholm L, Thonar EJ, Devogelaer JP: Oral salmon calcitonin reduces Lequesne's algofunctional index scores and decreases urinary and serum levels of biomarkers of joint metabolism in knee osteoarthritis. Arthritis Rheum. 54, 3205-3211 (2006).
Chesnut CH 3rd, Silverman S, Andriano K et al.: A randomized trial of nasal spray salmon calcitonin in postmenopausal women with established osteoporosis: the Prevent Recurrence of Osteoporotic Fractures Study. PROOF Study Group. Am. J. Med. 109, 267-276 (2000).
Mancini L, Paul-Clark MJ, Rosignoli G et al.: Calcitonin and prednisolone display antagonistic actions on bone and have synergistic effects in experimental arthritis. Am. J. Pathol. 170, 1018-1027 (2007).
