Skip to main content
SpringerLink
Log in

Nandrolone decanoate and intranasal calcitonin as therapy in established osteoporosis

  • Original Article
  • Published:
Osteoporosis International Aims and scope Submit manuscript

Abstract

This study used a randomized, 2 × 2 factorial design to evaluate over 2 years the effect of intranasal salmon calcitonin and intramuscular nandrolone decanoate on bone mass in elderly women with established osteoporosis. The study was double masked in relation to calcitonin and open in relation to nandrolone decanoate. One hundred and twenty-three women aged 60–88 years who had sustained a previous osteoporotic fracture, or had osteopenia, were recruited through an outpatient clinic. Women were assigned to one of four groups: (1) daily placebo nasal spray, (2) 400 IU intranasal calcitonin daily, (3) 20 intramuscular injections of 50 mg nandrolone decanoate (given as two courses of 10 injections) plus placebo nasal spray, or (4) 20 injections of 50 mg nandrolone decanoate plus 400 IU intranasal calcitonin daily. All subjects received 1000 mg calcium supplementation daily. Outcomes measured included changes in bone mineral density (BMD) at the lumbar spine, as measured by dual-energy quantitative computed tomography (DEQCT), in BMD of the proximal femur, and BMD and bone mineral content (BMC) of the lumbar spine and forearm, as measured by dual-energy X-ray absorptiometry (DXA). Significant positive changes from baseline in DXA BMC at the lumbar spine were observed over 2 years in the calcitonin group (5.0±1.9%, mean ± SE) and in the nandrolone deconate group (4.7±1.9%) but not in the placebo group (1.1±2.2%) or the combined therapy group (0.7±1.8%). Modelling based on the 2×2 factorial design revealed that nandrolone decanoate was associated with a 3.8±1.8% (p<0.05) gain in DXA BMD at the proximal femur. Modelling also revealed that calcitonin treatment was associated with a loss of 11.5±4.7% in DEQCT BMD at the lumbar spine and a loss of 3.7±1.8% in DXA BMD at the proximal femur (p<0.05). There was in vivo antagonism between the two medications of 7.9±3.9% for DXA BMC at the lumbar spine. Both agents caused positive changes from baseline in lumbar spine BMC. Nandrolone decanoate had beneficial effects on BMD at the proximal femur. This dose of intranasal calcitonin was associated with deleterious effects on trabecular BMD at the lumbar spine and total BMD at the proximal femur. There may be significant clinical antagonism between these two medications.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Similar content being viewed by others

References

  1. Lindsay R, Tohme JF. Estrogen treatment of patients with established postmenopausal osteoporosis. Obstet Gynecol 1990;76:290–5.

    Google Scholar 

  2. Christiansen C, Riis BJ. 17β-Estradiol and continuous norethis-terone: a unique treatment for established osteoporosis in elderly women. J Clin Endocrinol Metab 1990;71:836–41.

    Google Scholar 

  3. Reid IR, Ames RW, Evans MC, Gamble GD, Sharpe SJ. Effect of calcium supplementation on bone loss in postmenopausal women. N Engl J Med 1993;328:460–4.

    Google Scholar 

  4. Riggs BL, Hodgson SF, O'Fallon WM, et al. Effect of fluoride treatment on the fracture rate in postmenopausal women with osteoporosis. N Engl J Med 1990;322:802–9.

    Google Scholar 

  5. Watts NB, Harris ST, Genant HK, et al. Intermittent cyclical etidronate treatment of postmenopausal osteoporosis. N Engl J Med 1990;323:73–9.

    Google Scholar 

  6. Tillyard MW, Spears GF, Thomson J, Dovey S. Treatment of postmenopausal osteoporosis with calcitriol or calcium. N Engl J Med 1992;326:357–62.

    Google Scholar 

  7. Kopera H. The history of anabolic steroids and a review of clinical experience with anabolic steroids. Acta Endocrinol 1985;110 (Suppl 271):11–8.

    Google Scholar 

  8. Geusens P, Dequeker J. Long-term effect of nandrolone deca-noate, 1 α-hydroxyvitamin D3 or intermittent calcium infusion therapy on bone mineral content, bone remodelling and fracture rate in symptomatic osteoporosis: a double-blind controlled study. Bone Miner 1986;1:347–57.

    Google Scholar 

  9. Geusens P, Dequeker J, Verstraeten A, Nijs J, Van Holsbeeck M. Bone mineral content, cortical thickness and fracture rate in osteoporotic women after withdrawal of treatment with nandrolone decanoate, 1-alpha hydroxyvitamin D3, or intermittent calcium infusions. Maturitas 1986;8:281–9.

    Google Scholar 

  10. Need AG, Morris HA, Hartley TF, Horowitz M. Nordin BEC. Effects of nandrolone decanoate on forearm mineral density and calcium metabolism in osteoporotic postmenopausal women. Calcif Tissue Int 1987;41:7–10.

    Google Scholar 

  11. Johansen JS, Hassager C, Podenphant J, et al. Treatment of postmenopausal osteoporosis: is the anabolic steroid nandrolone decanoate a candidate? Bone Miner 1989;6:77–86.

    Google Scholar 

  12. Need AG, Horowitz M, Walker CJ, Chatterton BE, Chapman IC, Nordin BEC. Cross-over study of fat-corrected forearm mineral content during nandrolone decanoate therapy for osteoporosis. Bone 1989;10:3–6.

    Google Scholar 

  13. Gennari C, Agnus-Dei D, Gannelli S, Nardi P. Effects of nandrolone decanoate therapy on bone mass and calcium metabolism in women with established postmenopausal osteoporosis: a double-blind placebo-controlled study. Maturitas 1989;11:187–97.

    Google Scholar 

  14. Passed M, Pedrazzoni M, Pioli G, Battarini L, Ruys AH, Cortenraad MG. Effects of nandrolone decanoate on bone mass in established osteoporosis. Maturitas 1993;17:211–19.

    Google Scholar 

  15. Lyritis GP, Androulakis C, Magiasis B, Charalambaki Z, Tsakalakos N. Effect of nandrolone decanoate and 1α-hydroxy-calciferol on patients with vertebral osteoporotic collapse: a double-blind clinical trial. Bone Miner 1994;27:209–17.

    Google Scholar 

  16. Erdtsieck RJ, Pols HAP, Kuijk CV, Birkenhager-Frenkel DH, Zeelenberg J, Kooy PPM, et al. Course of bone mass during and after hormonal replacement therapy with and without addition of nandrolone decanoate. J Bone Miner Res 1994;9:277–83.

    Google Scholar 

  17. Gruber HE, Ivey JL, Baylink DJ, Matthews M, Nelp WB, Sisom K, Chesnut CH III. Long-term calcitonin therapy in postmenopausal osteoporosis. Metabolism 1984;33:295–303.

    Google Scholar 

  18. Reginster JY, Albert A, Lecart MP, Lambellin P, Denis D, Deroisy R, Fontane MA, Franchimont P. One year controlled randomised trial of prevention of early postmenopausal bone loss by intranasal calcitonin. Lancet 1987;2:1481–3.

    Google Scholar 

  19. Overgaard K, Riis BJ, Christiansen C, Hansen MA. Effect of salcatonin given intranasally on early postmenopausal bone loss. BMJ 1989;299:477–9.

    Google Scholar 

  20. Overgaard K, Riis BJ, Christiansen C, Podenphant J, Johansen JS. Nasal calcitonin for treatment of established osteoporosis. Clin Endocrinol 1989;30:435–42.

    Google Scholar 

  21. Overgaard K, Hansen MA, Jensen SB, Christiansen C. Effect of salcatonin given intranasally on bone mass and fracture rates in established osteoporosis: a dose-response study. BMJ 1992;305:556–61.

    Google Scholar 

  22. Szucs J, Horvath C, Kollin E, Szathmari M, Hollo I. Three-year calcitonin combination therapy for postmenopausal osteoporosis with crush fractures of the spine. Calcif Tissue Int 1992;50:7–10.

    Google Scholar 

  23. Reinbold WD, Genant HK, Reiser JJ, Harris ST, Ettinger B. Bone mineral content in early-postmenopausal and postmenopausal osteoporotic women: comparison of measurement methods. Radiology 1986;160:469–78.

    Google Scholar 

  24. Flicker L, Green R, Kaymakci B, Lichtenstein M, Buirski G, Wark JD. Do Australian women have greater spinal bone density than North American women? Osteoporosis Int 1995;5:63–5.

    Google Scholar 

  25. McCullagh P, Nelder JA, Generalized linear models. 2nd ed. Monographs on statistics and applied probability no. 37. London: Chapman & Hall, 1989.

    Google Scholar 

  26. Thamsborg G, Jensen JE, Kollerup G, Hauge EM, Melsen F, Sorensen OH. Effect of nasal salmon calcitonin on bone remodelling and bone mass in postmenopausal osteoporosis. Bone 1996;18:207–12.

    Google Scholar 

  27. Doers T, Pienkowski D, Faugere MC, Malluche HH. Calcitonin reduces bone mineral density and torsional mechanical properties of canine long bones. J Bone Miner Res 1994;9:S268.

    Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Department of Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia

    L. Flicker (Senior Lecturer in Geriatric Medicine), R. G. Larkins & J. D. Wark

  2. Department of Public Health and Community Medicine, University of Melbourne, Melbourne, Australia

    J. L. Hopper

  3. Nuclear Medicine, Royal Melbourne Hospital, University of Melbourne, Melbourne, Australia

    M. Lichtenstein

  4. Department of Radiology, University of Melbourne, Melbourne, Australia

    G. Buirski

Authors
  1. L. Flicker
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. J. L. Hopper
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. R. G. Larkins
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. M. Lichtenstein
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. G. Buirski
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. J. D. Wark
    View author publications

    You can also search for this author in PubMed Google Scholar

Rights and permissions

Reprints and permissions

About this article

Cite this article

Flicker, L., Hopper, J.L., Larkins, R.G. et al. Nandrolone decanoate and intranasal calcitonin as therapy in established osteoporosis. Osteoporosis Int 7, 29–35 (1997). https://doi.org/10.1007/BF01623456

Download citation

  • Received:

  • Accepted:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01623456

Keywords

Search

Navigation