Martin T J
Aust N Z J Med. 1979 Feb;9(1):36-43. doi: 10.1111/j.1445-5994.1979.tb04110.x.
Calcitonin has been used in the treatment of Paget's Disease of bone because of its ability to inhibit osteoclastic bone resorption. This results in a return of bone turnover towards normal, as reflected by urinary hydroxyproline and serum alkaline phosphatase. A plateau is reached with these parameters, at about 50% of the pre-treatment level. The cause of this plateau is unknown, but does not indicate resistance to treatment, since it occurs with all forms of calcitonin. Most treated patients experience pain relief, and there is radiological and histological evidence of arrested progression of Paget's Disease in patients treated with calcitonin. Both primary and secondary resistance to calcitonin occur with all calcitonins, including homologous hormone. Antibodies develop commonly in patients treated with pig or salmon calcitonin, but antibody-based clinical resistance has been demonstrated only in a few patients. Methods of selection of patients for treatment and of assessment of response are discussed, and treatment schedules summarized.
降钙素因其抑制破骨细胞骨吸收的能力，已被用于治疗骨Paget病。这导致骨转换恢复正常，尿羟脯氨酸和血清碱性磷酸酶反映了这一点。这些参数达到一个平台期，约为治疗前水平的50%。这个平台期的原因尚不清楚，但并不表明对治疗有抵抗，因为它在所有形式的降钙素治疗中都会出现。大多数接受治疗的患者疼痛缓解，并且有放射学和组织学证据表明，接受降钙素治疗的患者Paget病的进展得到了抑制。对降钙素的原发性和继发性抵抗在所有降钙素中都会出现，包括同源激素。在用猪或鲑鱼降钙素治疗的患者中通常会产生抗体，但仅在少数患者中证明了基于抗体的临床抵抗。本文讨论了治疗患者的选择方法和反应评估方法，并总结了治疗方案。
