Table 1.

Trials on the anti-fracture efficacy and analgesic effects of intranasal and oral calcitonin.

Reference	N	Intervention	Outcome
Chestnut et al. (2000)[4]	1255 (511 completed full 5-year follow up)	Daily nasal salmon calcitonin (100, 200 or 400 IU) vs placebo over 5 years	Daily 200 IU nasal calcitonin significantly reduced vertebral fracture risk. The 100 IU nasal calcitonin group experienced significantly fewer non-vertebral fractures compared to placebo. All dosages significantly increased vertebral BMD compared to placebo. Significant reductions in bone resorption markers were observed in 200 IU and 400 IU groups.
Henriksen et al. (2016)[37]	4665	Daily 0.8mg oral salmon calcitonin vs placebo over 36 months	Oral salmon calcitonin did not significantly reduce vertebral and non-vertebral fractures risk compared to placebo. The treatment group experienced a significantly greater increase in lumbar spine BMD than placebo but not in total hip or femoral neck BMD. Bone resorption markers were significantly lower in oral calcitonin arm than placebo arm at 12 and 24 months but not at 36 months.
Lyritis et al. (1991)[42]	56	Daily calcitonin 100 IU vs placebo injections for osteoporotic vertebral fractures, over 14 days	Calcitonin 100IU yielded significant reductions in pain (p<0.001) compared to placebo. These were apparent as early as day 2 of the treatment period. Urinary hydroxyproline and urinary calcium were significantly lower in the calcitonin group.
Lyritis et al. (1999)[43]	40	Daily 200 IU calcitonin suppositories vs placebo over 28 days	Daily calcitonin suppositories demonstrated significant analgesic efficacy on VAS scores compared to placebo in patients with recent osteoporotic vertebral fractures.
Karponis et al. (2015)[33]	41	Daily 200 IU intranasal calcitonin vs placebo over 3 months	Nasal calcitonin demonstrates a statistically significant analgesic efficacy after distal radius fractures when compared to placebo.