this figure we see a representation of the several types of response
to salmon calcitonin therapy. Bone turnover is clinically defined
by measuring serum alkaline phosphatase and/or urinary collagen components.
In patients with mild disease and approximately twice normal alkaline
phosphatase levels, chronic treatment usually results in a normalization
of alkaline phosphatase levels (bottom curve). A small percentage
of patients do not appear to respond and seem to show primary resistance
(primary nonresponse). In patients with more severe disease, generally
there is a long-term response with an approximately 50% decrease in
alkaline phosphatase (plateau response). About 10% to 20% of patients
have an initial response followed by a return to pretreatment levels.
The great majority of these resistant patients have high titers of
antibodies to salmon calcitonin.
Source: Hosking DJ. Chronic treatment with salmon calcitonin. Drugs.
1985;30:156-173. (Fig. 3).