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Salmon nasal calcitonin not effective for lumbar spinal stenosis

After four weeks, changes in key outcome scores among patients receiving salmon calcitonin vs. placebo were not significantly different.

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BERGEN, Norway — British investigators presented strong evidence that using salmon nasal calcitonin is ineffective for treating patients with lumbar spinal stenosis.

Phil Sell, FRCS, of University Hospitals of Leicester, England, presented results of the randomized, double-blinded and placebo-controlled trial at the International Society for Study of the Lumbar Spine 33rd Annual Meeting, here.

Salmon nasal calcitonin had been shown to be effective in mild cases of Paget’s disease. And early reports suggested it might be used subcutaneously to treat lumbar spinal stenosis (LSS). However, more recent studies prove the substance ineffective, he said.

Sell and colleagues studied this area because they sought evidence for a nonoperative clinical tool for LSS. The researchers randomized 40 patients with LSS confirmed by claudication symptoms and MRI to receive 200 IU of either nasal calcitonin or sodium chloride placebo nasal spray for four weeks. All patients then discontinued the sprays for six weeks before initiating six weeks of daily treatment with 200 IU of the active calcitonin spray, switching the nostrils they used on alternate days.

At four weeks, we saw no clinically significant difference in any group, Sell said.

At the end of the study, 43% of patients reported poor outcomes, according to the abstract.

Patients in both groups experienced deteriorating Visual Analog Scale leg pain scores, averaging –15 mm for the active treatment group and –11 mm for the placebo group. Only slight improvements were seen in other outcomes.

For more information:

• Tafazal S, Ng L, Sell P. Randomized double blinded placebo-controlled trial on the effectiveness of nasal salmon calcitonin in the treatment of lumbar spinal stenosis. #16. Presented at the International Society for the Study of the Lumbar Spine 33rd Annual Meeting. June 14-17, 2006. Bergen, Norway.