Abstract
Human synthetic calcitonin has produced a striking clinical and biochemical remission in each of five patients with Paget's disease treated for four to twelve months. Bone pain was relieved and skin temperature over affected limbs reduced. Elevated total urinary hydroxyproline levels fell to within the normal range and serum-alkaline-phosphatase to normal or near normal values. In two patients in whom quantitative histological studies were carried out, the number of osteoclasts was markedly reduced. The new bone formed during therapy had a normal lamellar structure. As assessed by the 47-calcium kinetic studies, the enhanced rate of bone-calcium turnover fell progressively. Calcium balance became positive or more positive. In each of the three patients studied, plasma-parathyroid-hormone levels were within the normal range after treatment for at least nine months. Two patients in remission relapsed slowly when calcitonin was withheld; they responded fully with further treatment.
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