Passeri M, Palummeri E, Barbagallo M, Butturini L, Pedrazzoni M, Davoli L, Pioli G, Benassi L, Girasole G, Ciotti G
Minerva Endocrinol. 1989 Jan-Mar;14(1):57-62.
Different therapeutic regimens have been proposed by Authors in the treatment of involutional (and particularly postmenopausal) osteoporosis. Following the up to date concepts on bone remodelling, an ADFR (Activate, Depress, Free, Repeat) trial was performed in 20 females affected by involutional osteoporosis. They were treated with Calcitriol 2 mcg/d for 7 days, followed by a 21 days period of 100 U/d Salmon Calcitonin + 1 g/d Calcitonin, followed by a 2-month period of Calcium alone. The cycles were repeated for 1 year and the results of densitometric examinations (radial mineral content evaluated by single photon absorptiometer, and vertebral mineral content evaluated by dual photon absorptiometer) and of biochemical markers (Ca++, P, osteocalcin, alkaline phosphatase, hydroxyproline) controlled every 3 months, were compared with those obtained in a group of patients treated only with Salmon Calcitonin and in a group treated with Calcium for 1 year. After two therapeutical cycles radial bone mineral density significantly increased; vertebral bone density also increased but not significantly. The effects were more evident in comparison to calcitonin alone treatment. A significant reduction in serum osteocalcin was documented. At the end of the therapy no further improvement was registered. This suggests that some variations and adaptation of therapeutic strategy are needed to achieve a more important and substantial improvement of bone conditions.
作者们提出了不同的治疗方案用于治疗退行性（尤其是绝经后）骨质疏松症。根据最新的骨重塑概念，对20名患有退行性骨质疏松症的女性进行了ADFR（激活、抑制、自由、重复）试验。她们先接受2微克/天的骨化三醇治疗7天，随后是21天每天100单位鲑鱼降钙素+1克降钙素的治疗期，接着是单独补钙2个月的时期。这些周期重复进行1年，并将每3个月进行一次的骨密度检查结果（通过单光子吸收仪评估桡骨矿物质含量，通过双能光子吸收仪评估椎骨矿物质含量）以及生化指标（钙离子、磷、骨钙素、碱性磷酸酶、羟脯氨酸）与仅接受鲑鱼降钙素治疗的一组患者和接受补钙治疗1年的一组患者所获得的结果进行比较。经过两个治疗周期后，桡骨骨矿物质密度显著增加；椎骨密度也有所增加，但不显著。与单独使用降钙素治疗相比，效果更为明显。血清骨钙素显著降低。治疗结束时未再有进一步改善。这表明需要对治疗策略进行一些调整和优化，以实现骨骼状况更重要和实质性的改善。
