Evaluation of the efficacy of salmon calcitonin nasal spray on bone healing following open reduction and internal fixation of mandibular fractures — A randomized controlled trial

Roy, Aritra; Thulasiraman, Selvakumar; Panneerselvam, Elavenil; Doss, Guruprasad Thulasi; Selvaraj, Mary Nancy; Ganesh, Sriraam Kasi; Raja, Krishnakumar; Kangusamy, Boopathi

doi:10.1016/j.jcms.2021.08.002

Cited by 5 publications

(5 citation statements)

References 29 publications

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“…The effectiveness of calcitonin as an adjunct analgesic has also been described in the treatment of non-PLP pain conditions such as trigeminal neuralgia: when administered as a 50 IU injection in combination with standard lidocaine and methylprednisolone maxillary and mandibular blocks, calcitonin prolongs the duration of analgesia (without significantly impacting its magnitude of effect) compared with normal saline placebo [ 50 ]. In another study of 46 patients undergoing surgical management of maxillofacial fractures, calcitonin was not associated with lower subjective pain scores but did reduce the need for other analgesic agents in the postoperative period [ 51 ]. Finally, patients undergoing total hip arthroplasty facilitated by epidural anesthesia reported equianalgesic effects with a combined calcitonin/bupivacaine injectate compared with a combined fentanyl/bupivacaine injectate [ 52 ].…”

Section: Discussionmentioning

confidence: 99%

Calcitonin in the Treatment of Phantom Limb Pain: A Systematic Review

et al. 2023

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Introduction Phantom limb pain (PLP) refers to pain perceived in a part of the body removed by amputation or trauma. Despite the high prevalence of PLP following amputation and the significant morbidity associated with it, robust therapeutic approaches are currently lacking. Calcitonin, a polypeptide hormone, has recently emerged as a novel analgesic with documented benefits in the treatment of several pain-related conditions. Methods We present a systematic review that comprehensively evaluates the analgesic effects of calcitonin for patients with PLP. We searched MEDLINE, OLDMEDLINE, and PubMed Central databases with the key words "calcitonin” “phantom limb pain" and "phantom pain" to identify clinical studies evaluating the efficacy or effectiveness of calcitonin administration, in any form and dose, for the treatment of PLP. Additionally, Google Scholar was searched manually with the search term "calcitonin phantom limb pain". All four databases were searched from inception until 1 December 2022. The methodological quality of each included study was assessed using the Downs and Black checklist and the GRADE criteria were used to assess effect certainty and risk of bias. Results Our search identified 4108 citations, of which six ultimately met the criteria for inclusion in the synthesis. The included articles described a mix of open-label ( n = 2), prospective observational cohort ( n = 1), and randomized clinical trials ( n = 3). The most common treatment regimen in the current literature is a single intravenous infusion of 200 IU salmon-derived calcitonin. Conclusion The available evidence supported the use of calcitonin as either monotherapy or adjuvant therapy in the treatment of PLP during the acute phase, while the evidence surrounding calcitonin treatment in chronic PLP is heterogeneous. Given the limited treatment options for the management of PLP and calcitonin’s relatively wide therapeutic index, further research is warranted to determine the role that calcitonin may play in the treatment of PLP and other pain disorders. Supplementary Information The online version contains supplementary material available at 10.1007/s40263-023-01010-x.

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Section: Discussionmentioning

confidence: 99%

Calcitonin in the Treatment of Phantom Limb Pain: A Systematic Review

et al. 2023

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“…Calcitonin can promote the internalisation of the osteoclasts' ru ed border proteins into intracellular vesicles, thereby thwarting acid release and preventing the demineralisation of bone matrix [27]. There has been some literatures which indicated that calcitonin could facilitate bone healing in various clinical indications, including odontoid fracture[28], vertebral fracture [29] and mandibular fracture [21]. According to China's National Medical Products Administration, calcitonin is indicated for use in hypercalcaemia, Paget's disease of bone, male osteoporosis, perimenopausal and postmenopausal osteoporosis, secondary osteoporosis, bone pain, acute bone loss and progressive bone loss.…”

Section: Inhibition Of Calcitonin On Osteoclast Action and Bone Resor...mentioning

confidence: 99%

“…The exact mechanism behind the analgesic effect of calcitonin remains elusive, yet several theories have been proposed [20]. Calcitonin is likely to ease pain through both central and peripheral actions; central is mainly through promotion of increased beta-endorphin release, while peripheral is via serotoninergic and catecholaminergic receptor systems [21]. As its potency shown to be better than that of morphine and its tendency to cause fewer side-effects, calcitonin has been applied to treating pain even in terminally ill cancer patients [37].…”

Section: Analgesic Activity Of Calcitoninmentioning

confidence: 99%

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Preliminary evaluation of the clinical efficacy of salmon calcitonin nasal spray in patients with rotator cuff tears after arthroscopic repair: a retrospective study

Lyu

et al. 2023

Preprint

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Background Rotator cuff tears (RCTs) are the most common shoulder disorder, which can be effectively treated by arthroscopic technique. However, the re-tear rates following rotator cuff repair range from 10% in small tears to 91% in massive tears, leading to a failure of healing, particularly in patients with osteoporosis or acute bone loss. Calcitonin used for acute bone loss has currently become a consensus. This study aims to assess the efficacy of salmon calcitonin nasal spray (SCNS) in patients with RCTs after arthroscopic repair. Methods It was a retrospective study which involved patients affected by RCTs from January 2018 to December 2019. All of the patients accepted arthroscopic surgery and were divided into two groups, with or without use of SCNS after the surgery. Patients were evaluated with clinical examination, pain scores based on visual analog scale (VAS) and functional outcomes based on the Constant-Murley shoulder score (CMS) and simple shoulder test (SST) before surgery, at 3, 6, and 24 months after surgery. Results Groups 1 (control group) and 2 (study group) comprised 26 and 29 patients, respectively, who showed no significant differences in demographic characteristics (p>0.05). In general, the mean ± sd of patient age was 52.27 ± 8.53 years (range, 39–75 years). Among the patients, 28 (50.9%) were male, and 27 (49.1%) were female. Shoulder function (CMS, SST) improved over time in both groups (p<0.05). At 3 months, VAS, CMS and SST values in study group were superior to those in control group (p<0.05). However, this trend was not persisted at 6 and 24 months. Tendon re-tear was seen in two of the patients in control group, but there was no significant difference in re-tear rates in the two groups (p=0.219). No other post-surgical complication was found in either group. Conclusions Use of SCNS could significantly reduce postoperative pain level and improve shoulder function in the early stage after arthroscopic repair, but it could not decrease the rotator cuff re-tear rate. Prospective studies involving large samples are required to observe the long term effects further more.

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“…Furthermore, in a meta-analysis by Knopp-Sihota et al [ 107 ], calcitonin was shown to significantly reduce the severity of acute pain in recent osteoporotic vertebral compression fractures (VOCF) but not chronic pain severity. In addition to VOCF, calcitonin can be used as a short-term analgesic therapy for acute traumatic medullary fractures [ 108 ], mandibular fractures [ 109 ], and vertebral fractures [ 110 ]. However, intranasal calcitonin can easily cause headaches, rectal suppositories can cause gastrointestinal disorders and dizziness, and intramuscular injections can cause facial flushing, anorexia, and gastrointestinal irritation [ 111 ].…”

Section: Commonly Used Clinical Analgesicsmentioning

confidence: 99%

Chronic Pain after Bone Fracture: Current Insights into Molecular Mechanisms and Therapeutic Strategies

Zhao

Zhang

et al. 2022

Brain Sciences

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Bone fracture following traumatic injury or due to osteoporosis is characterized by severe pain and motor impairment and is a major cause of global mortality and disability. Fracture pain often originates from mechanical distortion of somatosensory nerve terminals innervating bones and muscles and is maintained by central sensitization. Chronic fracture pain (CFP) after orthopedic repairs is considered one of the most critical contributors to interference with the physical rehabilitation and musculoskeletal functional recovery. Analgesics available for CFP in clinics not only have poor curative potency but also have considerable side effects; therefore, it is important to further explore the pathogenesis of CFP and identify safe and effective therapies. The typical physiopathological characteristics of CFP are a neuroinflammatory response and excitatory synaptic plasticity, but the specific molecular mechanisms involved remain poorly elucidated. Recent progress has deepened our understanding of the emerging properties of chemokine production, proinflammatory mediator secretion, caspase activation, neurotransmitter release, and neuron-glia interaction in initiating and sustaining synaptogenesis, synaptic strength, and signal transduction in central pain sensitization, indicating the possibility of targeting neuroinflammation to prevent and treat CFP. This review summarizes current literature on the excitatory synaptic plasticity, microgliosis, and microglial activation-associated signaling molecules and discusses the unconventional modulation of caspases and stimulator of interferon genes (STING) in the pathophysiology of CFP. We also review the mechanisms of action of analgesics in the clinic and their side effects as well as promising therapeutic candidates (e.g., specialized pro-resolving mediators, a caspase-6 inhibitor, and a STING agonist) for pain relief by the attenuation of neuroinflammation with the aim of better managing patients undergoing CFP in the clinical setting.

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Evaluation of the efficacy of salmon calcitonin nasal spray on bone healing following open reduction and internal fixation of mandibular fractures — A randomized controlled trial

Cited by 5 publications

References 29 publications

Calcitonin in the Treatment of Phantom Limb Pain: A Systematic Review

Calcitonin in the Treatment of Phantom Limb Pain: A Systematic Review

Preliminary evaluation of the clinical efficacy of salmon calcitonin nasal spray in patients with rotator cuff tears after arthroscopic repair: a retrospective study

Chronic Pain after Bone Fracture: Current Insights into Molecular Mechanisms and Therapeutic Strategies

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