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There appears to be a consensus that 100 IU/day of nasally administered salmon calcitonin may prevent trabecular bone loss during the first years of the menopause. Strong evidence exists that half that dose may also be sufficient to prevent trabecular bone loss and that higher doses (> or = 200 IU/day) induce a significant increase in spinal bone mineral content. Calcium supplements should be systemically administered when calcitonin is given, particularly at high doses. Rectal calcitonin seems also to be an efficient alternative in prevention of trabecular bone loss. Further studies are required to evaluate the effect of calcitonin in prevention of cortical bone loss. In established osteoporosis, calcitonin may prevent further bone loss at trabecular and cortical sites. A similar benefit is obtained following parenteral or nasal admin...
Strontium ranelate, with its unique mode of action combining inhibition of bone resorption and stimulation of bone formation is characterized by a wide scatter of activity, both in terms of skeletal sites positively affected and of patients experiencing benefits of its administration. It is currently reimbursed, in Belgium, in osteoporotic patients aged 80 years and older. In this group, it is the only drug which has shown an extensive range of anti-fracture efficacy.
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