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Calcitonin for treating acute and chronic pain of recent and remote osteoporotic vertebral compression fractures: a systematic review and meta-analysis

Calcitonin for treating acute and chronic pain of recent and remote osteoporotic vertebral... Vertebral collapse is a common fracture associated with osteoporosis. Subsequent pain may be severe and often requires medications and bed rest. Several studies have suggested the use of calcitonin for the treatment of fracture pain. We sought to determine the analgesic efficacy of calcitonin for acute and chronic pain of osteoporotic vertebral compression fractures (OVCF). We searched for randomized, placebo, and controlled trials that evaluated the analgesic efficacy of calcitonin for pain attributable to OVCFs. We performed meta-analyses to calculate standardized mean differences (SMDs) using a fixed or random effects model. The combined results from 13 trials (n = 589) determined that calcitonin significantly reduced the severity of acute pain in recent OVCFs. Pain at rest was reduced by week 1 [mean difference (MD) = −3.39, 95% confidence interval (CI) = −4.02 to −2.76), with continued improvement through 4 weeks. At week 4, the difference in pain scores with mobility was even greater (SMD = −5.99, 95% CI = −6.78 to −5.19). For patients with chronic pain, there was no statistical difference between groups while at rest; there was a small, statistically significant difference between groups while mobile at 6 months (SMD = 0.49, 95% CI = −0.85 to −0.13, p = 0.008). Side effects were mild, with enteric disturbances and flushing reported most frequently. Although calcitonin has proven efficacy in the management of acute back pain associated with a recent OVCF, there is no convincing evidence to support the use of calcitonin for chronic pain associated with older fractures of the same origin. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Osteoporosis International Springer Journals

Calcitonin for treating acute and chronic pain of recent and remote osteoporotic vertebral compression fractures: a systematic review and meta-analysis

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References (94)

Publisher
Springer Journals
Copyright
Copyright © 2011 by International Osteoporosis Foundation and National Osteoporosis Foundation
Subject
Medicine & Public Health; Rheumatology; Orthopedics; Endocrinology; Gynecology
ISSN
0937-941X
eISSN
1433-2965
DOI
10.1007/s00198-011-1676-0
pmid
21660557
Publisher site
See Article on Publisher Site

Abstract

Vertebral collapse is a common fracture associated with osteoporosis. Subsequent pain may be severe and often requires medications and bed rest. Several studies have suggested the use of calcitonin for the treatment of fracture pain. We sought to determine the analgesic efficacy of calcitonin for acute and chronic pain of osteoporotic vertebral compression fractures (OVCF). We searched for randomized, placebo, and controlled trials that evaluated the analgesic efficacy of calcitonin for pain attributable to OVCFs. We performed meta-analyses to calculate standardized mean differences (SMDs) using a fixed or random effects model. The combined results from 13 trials (n = 589) determined that calcitonin significantly reduced the severity of acute pain in recent OVCFs. Pain at rest was reduced by week 1 [mean difference (MD) = −3.39, 95% confidence interval (CI) = −4.02 to −2.76), with continued improvement through 4 weeks. At week 4, the difference in pain scores with mobility was even greater (SMD = −5.99, 95% CI = −6.78 to −5.19). For patients with chronic pain, there was no statistical difference between groups while at rest; there was a small, statistically significant difference between groups while mobile at 6 months (SMD = 0.49, 95% CI = −0.85 to −0.13, p = 0.008). Side effects were mild, with enteric disturbances and flushing reported most frequently. Although calcitonin has proven efficacy in the management of acute back pain associated with a recent OVCF, there is no convincing evidence to support the use of calcitonin for chronic pain associated with older fractures of the same origin.

Journal

Osteoporosis International – Springer Journals

Published: Jun 10, 2011

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