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calcitonin (Calsynar / calcitonin, Aventis / Calcin)

✓ Approved

Sanofi S.A · CALCR · Polypeptide

What is calcitonin?

calcitonin is a polypeptide developed by Sanofi S.A. It is approved for therapeutic indications via inhaled.

Drug Profile

Brand NamesCalsynar, calcitonin, Aventis, Calcin
CompanySanofi S.A
Drug ClassPolypeptide
Molecular TargetCALCR
RouteInhaled
StatusApproved
Sources: ClinicalTrials.gov, Sanofi S.A

Mechanism of Action

Molecular Targets

calcitonin acts on 1 molecular target:

CALCRcalcitonin receptor (CT-R, CTR)
Want deeper analysis?Noah AI can explain complex mechanisms and compare to similar drugs.

Therapeutic Indications

calcitonin is developed for 3 unique indications across 2 therapeutic areas.

Therapeutic AreaConditionPhase
Surgical and medical proceduresHypercalcaemia therapy✓ Approved
Musculoskeletal and connective tissue disordersOsteitis deformans✓ Approved
Musculoskeletal and connective tissue disordersOsteoporosis✓ Approved

Related Research Articles

PubMedAutonomic neuroscience : basic & clinical2026-08-28

Immunohistochemical analysis of tyrosine hydroxylase, CGRP and TRPV1 in mouse colon myenteric plexus.

Sharrad Dale D, Hibberd Tim T, Siddiqui Ariba A, Travis Lee L et al.

In the gastrointestinal tract, spinal afferent and sympathetic efferent neurons are key regulators of motility, secretion, and sensation. Strong colocalization of the afferent markers calcitonin gene-related peptide (CGRP) and TRPV1 is established in mouse gut. However, the expression of these markers in sympathetic axons-identifiable by immunoreactivity for tyrosine hydroxylase (TH), the rate-limiting enzyme for noradrenaline synthesis- has not yet been characterized in the colon. Using multiple-label immunohistochemistry, we quantified the coexistence of CGRP, TRPV1, and TH in varicose axons in the myenteric plexus of the mouse proximal and mid colon. Approximately half of CGRP-immunoreactive (IR) varicosities were also TRPV1-IR in the proximal (48.5 ± 3.5) and mid colon (50.3 ± 3.5) and the great majority of TRPV1-IR varicosities were CGRP-IR in the proximal (87 ± 1.1) and mid colon (90 ± 3.3). In the proximal and mid colon, TH-IR varicosities were neither CGRP- or TRPV1-IR, and the converse was also true; CGRP- and TRPV1-IR varicosities were not TH-IR. Our observations reveal that while CGRP and TRPV1 expression largely occurs together in axons in the proximal and mid colon, there is a population of CGRP axons that do not express TRPV1. In varicose axons, TH expression is mutually exclusive from expression of CGRP and TRPV1. Together, the results support the notion that CGRP together with TRPV1 and TH serve as respective "neurochemical markers" to distinguish spinal afferents from sympathetic efferents in the murine GI tract.

PMID 42659771
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PubMedFrontiers in neurology2026-08-28

Tracking migraine outcomes over time by age and monoclonal antibody type: a retrospective, single-center, real-world study.

Mattioli Irene I, Rondina Alessandro A, Lanfranchi Alice A, Ceccardi Giulia G et al.

Calcitonin gene-related peptide (CGRP) monoclonal antibodies (mAbs) are established preventive treatments for episodic and chronic migraine, but comparative longitudinal data across agents and age groups remain limited. This study aimed to evaluate long-term responses to different CGRP mAbs, assess whether age or treatment type influences response trajectories, and characterize multidimensional patterns of clinical response. We conducted a retrospective, single-center observational study including 453 adults with episodic or chronic migraine treated with erenumab, galcanezumab, fremanezumab, or eptinezumab between November 2018 and April 2026. Patients were stratified by age (<50 vs. ≥ 50 years) and different CGRP mAbs treatment. Longitudinal mixed-effects models assessed changes in monthly migraine days, acute medication use, pain intensity, disability, quality of life, and mood over 12 months. Generalized linear mixed models evaluated predictors of ≥50% response. Principal component analysis (PCA) was used to identify multidomain response patterns. All CGRP mAbs produced rapid and sustained improvements across migraine frequency, disability, and patient-reported outcomes over 12 months. Age did not significantly influence baseline severity, longitudinal trajectories, or responder status. Treatment differences were modest overall; however, at 12 months, fremanezumab and eptinezumab were associated with higher odds of response compared with erenumab, while galcanezumab showed consistently higher response odds independent of time. PCA identified a General improvement component capturing multidomain benefit, which was more pronounced in the eptinezumab group. In real-world clinical practice, CGRP mAbs demonstrate comparable and durable effectiveness across age groups. Subtle long-term differences between agents may emerge, particularly for multidimensional clinical improvement, supporting individualized treatment selection.

PMID 42662958
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PubMedBone research2026-08-28

Sensory nerves regulate bone homeostasis in response to mechanical unloading or reloading: evidence from a spaceflight experiment and ground-based mechanical unloading models.

Tsujino Shohei S, Ochi Hiroki H, Okada Risa R, Kamimura Daisuke D et al.

Mechanical loading is crucial for maintaining bone mass, and understanding how bone remodels in response to mechanical loading is essential for treating musculoskeletal disorders. Recently, sensory nerves inside bone were identified as mechanical regulators of bone homeostasis. However, how the structure and networks of sensory nerves are altered in response to changes in mechanical loading remains unclear. To address this question, we performed a spaceflight experiment on the International Space Station (ISS) and used two ground-based mechanical unloading models, tail suspension (TS) and hindlimb immobilization. In a spaceflight experiment, Sox10-Venus mice, in which green fluorescent protein is expressed in nerve fibers, were housed at the ISS for 3 weeks, and we demonstrated that microgravity exposure significantly decreased bone mass and impaired nerve abundance inside the bone. These changes were reproduced in both ground-based models. Mechanical reloading after TS induced the recovery of bone mass and nerve abundance. Retrograde tracing experiments revealed that mechanical changes specifically affected sensory innervation inside bone without altering the number of neurons in the dorsal root ganglia. Notably, continuous administration of calcitonin gene-related peptide (CGRP), a neuropeptide secreted from sensory nerves, prevented unloading-induced bone loss. Furthermore, both surgical and genetic ablation of sensory nerves inhibited loading-induced trabecular bone recovery. These findings demonstrate that sensory nerves inside bone play a critical role in regulating bone homeostasis in response to mechanical changes and may aid in the development of therapeutic strategies for bone loss induced by mechanical unloading, such as prolonged bed rest and long-term space travel.

PMID 42660877
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PubMedBMC neurology2026-08-28

Real-world short-term effectiveness of erenumab after single versus multiple prior preventive treatment failures.

Schmidt Chantal C, Becker Lukas L, Lindner Diana D, Kleinschnitz Christoph C et al.

Erenumab, a monoclonal antibody targeting calcitonin gene-related peptide receptor, has been approved in Germany since 2018 for migraine prophylaxis. Initially, reimbursement regulations restricted its use to drug-resistant patients who had failed or were unsuitable for conventional preventive treatments. Over time, initiation after failure of only one prior preventive treatment became possible. As earlier initiation of effective preventive therapy may improve clinical outcomes, we compared the effectiveness of erenumab in patients with single versus multiple prior preventive treatment failures. In this retrospective single-center study, data from 196 patients with episodic or chronic migraine who received erenumab for at least three months were analysed. Patients were categorised into a multiple prior preventive therapy (MPT) group (n = 140), comprising individuals with two to six previous preventive treatment failures, and single preventive therapy (SPT) group (n = 56), including patients who had received no more than one prior treatment failure before initiating erenumab. To evaluate the association between prior treatment exposure and treatment response, a multivariate logistic regression analysis was performed with achievement of a ≥ 50% reduction in monthly headache days (MHD) as the primary outcome. Subgroup analyses, LASSO-based variable selection, and propensity score weighting were conducted as sensitivity analyses. A clinically meaningful treatment response (50% MHD response) was achieved by 35.7% (n = 20/56) of patients in the SPT group and 30.7% (n = 43/140) in the MPT group. No significant difference in treatment effectiveness was observed between groups. In the adjusted logistic regression model, SPT was not significantly associated with treatment response (SPT vs. MPT: adjusted OR 1.39, 95% CI 0.53-3.69; p = 0.5). Short-term effectiveness of erenumab was comparable in patients with no more than one versus multiple prior preventive treatment failures, suggesting that treatment response is not solely dependent on the number of previous preventive treatment failures. These findings should be interpreted in light of the retrospective single-center design and the limited sample size, which resulted in relatively wide confidence intervals.

PMID 42661173
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PubMedInvestigative ophthalmology & visual science2026-08-27

Protective Effect of Calcitonin Gene-Related Peptide on Corneal Epithelial Barrier in Experimental Dry Eye Models.

Shi Jintao J, He Huan H, Liu Aolin A, He Wanling W et al.

To investigate the role of calcitonin gene-related peptide (CGRP) in corneal epithelial barrier dysfunction in dry eye disease (DED). Benzalkonium chloride (BAC)-induced murine dry eye models and hyperosmotic-stressed human corneal epithelial cells-transformed (HCE-T) were used. Corneal nerve density and CGRP expression were assessed via whole-mount staining and Western blot. CGRP receptor components, including CRLR, RAMP-1, and CRCP, were evaluated by quantitative real-time PCR and immunofluorescence. Mice received a topical CGRP solution (50 µM) for four days. Barrier function was analyzed using Oregon Green Dextran (OGD) staining and transepithelial electrical resistance (TEER). Tight junction proteins, inflammatory markers, and PKA/CREB/NF-κB signaling pathways were examined via immunofluorescence, qPCR, and Western blot. BAC exposure caused significant corneal nerve damage (P < 0.05) and a reduction of CGRP levels (P < 0.001), accompanied by upregulation of CGRP receptor components (CRLR, RAMP-1, CRCP; P < 0.05). Exogenous CGRP treatment restored corneal epithelial barrier function, as indicated by decreased OGD staining intensity (P < 0.001) and improved TEER (P < 0.001), while maintaining the localization of tight junction proteins. Mechanistically, CGRP increased p-PKACα (T197)/PKACα and p-CREB (S133)/CREB (P < 0.01), while reducing p-p65 and IL-1β, IL-6, TNF-α, MMP-9 (P < 0.01). These effects were observed in both BAC-induced DED mice and in hyperosmotic-stressed human corneal epithelial cells, demonstrating that CGRP exerts dual mechanisms in barrier repair and anti-inflammatory protection. CGRP deficiency and receptor upregulation may be involved in the pathological process of DED. Exogenous CGRP ameliorates corneal barrier dysfunction, which is associated with modulation of the PKA/CREB and NF-κB pathways.

PMID 42657999
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PubMedFrontiers in drug safety and regulation2026-08-27

Deprescribing and Anti-CGRP preventive therapy in medication-overuse headache associated with migraine: pathophysiological rationale and single-center real world evidence.

Sošić Matija M, Rački Valentino V, Fajkić Almir A, Jašić Mladen M et al.

Medication-overuse headache (MOH) associated with migraine is a biologically driven disorder involving central sensitization, maladaptive neuroplasticity, and enhanced calcitonin gene-related peptide (CGRP) signaling. While structured deprescribing addresses medication-related drivers, withdrawal alone often provides limited and unsustained benefit. Anti-CGRP preventive therapies offer targeted modulation of migraine pathways without reinforcing medication overuse. This study integrates pathophysiological insights with real-world evidence from a single-center study of 47 patients treated with combined deprescribing and anti-CGRP therapy. Clinically meaningful reductions in monthly migraine days were observed, with 85.1% achieving ≥50% reduction at 6 months and 78.7% achieving >75% reduction at 12 months. Our clinical experience also suggests that long-standing combination analgesic overuse may be associated with a slower treatment response. The present findings support a mechanism-based treatment approach and suggest that combining preventive therapy with deprescribing may optimize long-term outcomes in patients with migraine-associated MOH.

PMID 42656737
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