Osteoporosis: elcatonin partly efficacious in 3-year study

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Takeaway

  • The calcitonin derivative elcatonin (EL), given for 3 years, increases lumbar bone mineral density (BMD) but has no effect on incidence of vertebral fractures, according to a randomized controlled trial (RCT).

Why this matters

  • Results may not be strong enough to warrant change in clinical practice in countries where elcatonin is available.

Study design

  • Multicenter, double-blind RCT of EL (n=433; 20 units once-weekly intramuscularly for 144 weeks) vs placebo (n=436) in patients with osteoporosis and prior vertebral fracture(s).
  • Primary outcome was incidence of new vertebral fractures at 24, 48, 72, 96, 120, and 144 weeks.
  • Funding: Asahi Kasei Pharma Corporation.

Key results

  • There was no difference in incidence of vertebral fracture in EL vs placebo groups.
  • EL group had higher percentage increase in lumbar BMD vs placebo at all points (all P<.05>
  • At 144 weeks, EL group had higher percentage increase (± standard error) in lumbar BMD (2.13±0.59% vs −0.58±0.53% in the placebo group; P=.008).
  • No difference between groups in hip total and femoral neck BMD.
  • No new safety concerns emerged in comparison with previous trials.
  • Limitations

    • 16.2% of patients in the EL group and 12.4% of those in the placebo group did not have vertebral fracture at baseline, despite inclusion criteria.