Management of aromatase inhibitor induced musculoskeletal symptoms in postmenopausal early Breast cancer: A systematic review and meta-analysis

Roberts, Kate; Rickett, Kirsty; Greer, Ristan M.; Woodward, Natasha

doi:10.1016/j.critrevonc.2017.01.010

Cited by 50 publications

(46 citation statements)

References 61 publications

(80 reference statements)

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“…Other small scale studies of exercise to reduce AIAA have explored aquatic exercise , Nordic walking , and an 8‐week home‐based aerobic and resistance exercise program , and all have reported promising benefits. Recent meta‐analyses of AIAA management interventions rated the overall evidence regarding exercise to reduce AIAA as moderate and that further studies are needed .…”

Section: Discussionmentioning

confidence: 99%

“…Joint symptoms of pain, stiffness, and achiness (arthralgia) are commonly reported side effects of AI treatment, affecting an estimated 33%–74% of breast cancer patients on AI therapy seen in clinical practice, and rated moderate to severe by as many as 70% of women who report them . For most breast cancer survivors experiencing AI‐associated arthralgia (AIAA), pharmacological remedies such as analgesics and antidepressants provide little or no joint symptom relief . There is a need to identify effective, easy‐to‐use, sustainable, and safe alternative or adjunctive approaches to AIAA management, so that they are able to remain on AI therapy while having as pain‐free a life as possible.…”

Section: Introductionmentioning

confidence: 99%

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Randomized Controlled Trial of a Home-Based Walking Program to Reduce Moderate to Severe Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors

et al. 2017

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For most breast cancer survivors experiencing aromatase inhibitor‐associated arthralgia (AIAA), pharmacological remedies such as analgesics and antidepressants provide little or no joint symptom relief, and these medications have their own adverse side effects. There is a need to identify effective, easy‐to‐use, sustainable, and safe alternative or adjunctive approaches to AIAA management. This article describes an evidence‐based walking program that is effective in reducing symptoms in adults with arthritis and investigates whether the program could have similar benefits for women experiencing AIAA.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Randomized Controlled Trial of a Home-Based Walking Program to Reduce Moderate to Severe Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors

et al. 2017

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“…Providing patients with additional information material does not appear to affect compliance and persistence with anastrozole [23]. Although yoga has been reported to significantly improve musculoskeletal symptoms in various trials [17,19,24,25], there are contradictory results in relation to physical activity [18,19,26,27]; and the same applies to acupuncture [19,20,28,29] and other complementary and alternative medicines (CAM) [19,30,31].…”

Section: Introductionmentioning

confidence: 99%

Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients

et al. 2020

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a b s t r a c tBackground: Patients with breast cancer (BC) show strong interest in complementary and alternative medicine (CAM), particularly for adverse effects of adjuvant endocrine treatment d e.g., with letrozole. Letrozole often induces myalgia/limb pain and arthralgia, with potential noncompliance and treatment termination. This analysis investigated whether CAM before aromatase inhibitor (AI) therapy is associated with pain development and the intensity of AI-induced musculoskeletal syndrome (AIMSS) during the first year of treatment. Patients and methods: The multicenter phase IV PreFace study evaluated letrozole therapy in postmenopausal, hormone receptorepositive patients with early BC. Patients were asked about CAM use before, 6 months after, and 12 months after treatment started. They recorded pain every month for 1 year in a diary including questions about pain and numeric pain rating scales. Data were analyzed for patients who provided pain information for all time points. Results: Of 1396 patients included, 901 (64.5%) had used CAM before AI treatment. Throughout the observation period, patients with CAM before AI treatment had higher pain values, for both myalgia/limb pain and arthralgia, than non-users. Pain increased significantly in both groups over time, with the largest increase during the first 6 months. No significant difference of pain increase was noted regarding CAM use. Conclusions: CAM use does not prevent or improve the development of AIMSS. Pain intensity was generally greater in the CAM group. Therefore, because of the risk of non-compliance and treatment discontinuation due to the development of higher pain levels, special attention must be paid to patient education and aftercare in these patients.

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“…Therefore, there is a need to explore the underlying symptom mechanisms, identify predictors of women at greatest risk (Henry & Stearns, 2011 ;Olufade, Gallicchio, MacDonald, & Helzlsouer, 2015 ), and develop both pharmacologic and nonpharmacologic interventions to relieve these symptoms. Studies have examined various approaches for such relief, including vitamin D, yoga, acupuncture, physical activity, pharmacology, and complementary interventions (Nahm, Mee, & Marx, 2018 ;Roberts, Rickett, Greer, & Woodward, 2017 ). Many studies, however, have limitations in terms of small sample size, short intervention period, and lack of follow-up measurement (Nahm et al, 2018 ;Roberts et al, 2017 ).…”

Section: Discussionmentioning

confidence: 99%

“…Studies have examined various approaches for such relief, including vitamin D, yoga, acupuncture, physical activity, pharmacology, and complementary interventions (Nahm, Mee, & Marx, 2018 ;Roberts, Rickett, Greer, & Woodward, 2017 ). Many studies, however, have limitations in terms of small sample size, short intervention period, and lack of follow-up measurement (Nahm et al, 2018 ;Roberts et al, 2017 ). Using selfreported outcome measures also raises questions on how accurately the women can identify AI-related musculoskeletal symptoms versus non-AI-related musculoskeletal symptoms or other symptoms that can be mistaken for musculoskeletal symptoms (Nahm et al, 2018 ).…”

Section: Discussionmentioning

confidence: 99%

Endocrine Therapy–Related Symptoms and Quality of Life in Female Cancer Survivors in the Yale Fitness Intervention Trial

Park

Jeon

2019

J of Nursing Scholarship

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Purpose The aim of the current study was to describe and compare endocrine therapy–related symptoms and quality of life in female cancer survivors taking aromatase inhibitors, tamoxifen, and no endocrine therapy, and to evaluate the effect of an exercise intervention on these symptoms and quality of life. Design Randomized controlled trial. An aerobic resistance exercise intervention group was compared with a home‐based exercise control group over 1 year. The exercise intervention was supervised for the first 6 months, followed by 6 unsupervised months. Methods Perimenopausal and early postmenopausal female cancer survivors within 3 years of completing primary or adjuvant chemotherapy were selected. A total of 154 women were enrolled in the study. Type of endocrine or hormonal therapy was documented. Symptoms were measured by the Breast Cancer Prevention Trial Symptom Checklist and the Functional Assessment of Cancer Therapy‐Endocrine Subscale. Quality of life was measured by the Functional Assessment of Cancer Therapy‐General. Data were collected at baseline, and at 6 and 12 months. Findings Participants generally had mild symptom distress. There was no difference in symptoms by endocrine therapy group or by exercise group. Participants taking aromatase inhibitors in the aerobic resistance exercise intervention group reported significant improvement in social, family, and functional well‐being and better quality of life compared to those in the control group at 6 months but not at 12 months. Conclusions Findings were similar to those of previous large clinical trials in that no significant differences were found for endocrine therapy–related symptoms and quality of life by type of endocrine therapy taken. However, exercise may improve quality of life outcomes for women taking aromatase inhibitors. Clinical Relevance Exercise has established efficacy for patient outcomes such as cardiovascular fitness, fatigue, weight management, and quality of life and may provide better quality of life for women who take aromatase inhibitors as adjuvant therapy.

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Management of aromatase inhibitor induced musculoskeletal symptoms in postmenopausal early Breast cancer: A systematic review and meta-analysis

Cited by 50 publications

References 61 publications

Randomized Controlled Trial of a Home-Based Walking Program to Reduce Moderate to Severe Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors

Randomized Controlled Trial of a Home-Based Walking Program to Reduce Moderate to Severe Aromatase Inhibitor-Associated Arthralgia in Breast Cancer Survivors

Complementary and alternative medicine and musculoskeletal pain in the first year of adjuvant aromatase inhibitor treatment in early breast cancer patients

Endocrine Therapy–Related Symptoms and Quality of Life in Female Cancer Survivors in the Yale Fitness Intervention Trial

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