Comparison of the analgesic efficacy of pamidronate and synthetic human calcitonin in osteoporotic vertebral fractures: a double-blind controlled study

Our aim was to compare the analgesic efficacy of pamidronate (PAM) and synthetic human calcitonin (CT) in intravenous infusion for recent painful benign vertebral compression in a randomised prospective double-blind study. Twenty-seven patients aged 49–85 years with painful benign non-traumatic vertebral compression were included in the study. They received either PAM (1 mg/kg) or synthetic human CT (1.5 mg) as an intravenous infusion. Pain and functional disability were evaluated before infusion, and 4 and 30 days afterwards. The pain score assessed on a visual analogue scale at day 0 was 5.94±2.47 in patients treated with PAM and 6.27±2.50 in patients treated with CT (p=0.74); at day 4, 4.8±2.80 with PAM vs 3.9±2.68 with CT (p=0.37); and at day 30, 3.6±3.13 with PAM vs 3.10±2.76 with CT (p=0.70). Spinal function scores were 18.21±3.17 at day 0 in patients treated with PAM vs 17.23±4.42 in patients treated with CT (p=0.69) and at day 30, 13.7±5.36 with PAM vs 12.33±3.22 with CT (p=0.68). We found no advantage of PAM over CT in a single intravenous infusion for the treatment of painful recent benign vertebral compression. Since CT is ten times less costly, its use should be preferred.