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Chronic Treatment with Salmon Calcitonin  
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  In 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).
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