Is calcitonin a second line treatment option for osteoporosis?
Calcitonin, an anti-resorptive agent, is considered a second line drug for treatment of osteoporosis as it is a less potent than bisphosphonates, SERMs, and teriperitide, all of which have been to shown significantly reduce fracture rates. Calcitonin is reserved as an alternative for women who have contraindications or prefer it to using first line osteoporosis medications. It has been FDA approved for treatment of osteoporosis (not prevention) and is recommended in women > than 5 years post menopause as the efficacy has not been observed in early postmenopausal women. Although nasal calcitonin has been found to increase lumbar spine BMD in men with idiopathic osteoporosis and in both men and women with corticosteroid-induced osteoporosis, there is no evidence that it reduces fracture rates and therefore is not a first line treatment option in these patient populations (1,2).
