Randomized Exercise Trial of Aromatase Inhibitor–Induced Arthralgia in Breast Cancer Survivors

Irwin, Melinda L.; Cartmel, Brenda; Gross, Cary P.; Ercolano, Elizabeth; Li, Fangyong; Yao, Xiaopan; Fiellin, Martha; Capozza, Scott; Rothbard, Marianna; Zhou, Yang; Harrigan, Maura; Sanft, Tara; Schmitz, Kathryn H.; Neogi, Tuhina; Hershman, Dawn L.; Ligibel, Jennifer A.

doi:10.1200/jco.2014.57.1547

Cited by 270 publications

(267 citation statements)

References 30 publications

Supporting

Mentioning

251

Contrasting

Unclassified

Order By: Relevance

“…Of the 3 RCTs, there was only one study showing benefit with physical therapy (35). The HOPE study, by Irwin et al, was the largest of the exercise studies in our analysis, with 121 participants (35).…”

Section: Resultsmentioning

confidence: 99%

“…Of the 11 assessable RCTs, eight studies had a high Jadad score ≥3 (26)(27)(28)(29)(30)(31)(32)(33). Three studies scored poorly on the Jadad scale for methodological quality (34)(35)(36). Only six cohort studies had full-text available for assessment with the Newcastle Ottowa Scale.…”

Section: Methodsological Quality Of Selected Studiesmentioning

confidence: 99%

“…Therefore, the physical therapy interventions were extremely heterogeneous, ranging from two one hour tai chi sessions per week for 8 weeks (60), to 150 minutes of aerobic exercise weekly plus supervised strength training twice weekly (35). The mean sample size between studies was 31 patients (range 10-121).…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

“…Three studies investigated a combined aerobic and resistance exercise program, including two randomised control trials (35,56), and one pre/post study (57). One pre/post study investigated a home-based exercise program (58), and two studies investigated walking programs, including one RCT involving Nordic Walking (33), and one pre/post study investigating a self-directed walking program (59).…”

Section: Characteristics Of Studiesmentioning

confidence: 99%

See 3 more Smart Citations

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

Roberts

Rickett

Greer

et al. 2017

Critical Reviews in Oncology/Hematology

View full text Add to dashboard Cite

Section: Resultsmentioning

confidence: 99%

Section: Methodsological Quality Of Selected Studiesmentioning

confidence: 99%

Section: Characteristics Of Studiesmentioning

confidence: 99%

Section: Characteristics Of Studiesmentioning

confidence: 99%

See 2 more Smart Citations

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

Roberts

Rickett

Greer

et al. 2017

Critical Reviews in Oncology/Hematology

View full text Add to dashboard Cite

“…Furthermore, a recently reported trial conducted in the U.S. has provided further evidence that exercise may help reduce pain in women with AIAA. 56 …”

Section: Discussionmentioning

confidence: 99%

Nordic Walking as an Exercise Intervention to Reduce Pain in Women With Aromatase Inhibitor–Associated Arthralgia: A Feasibility Study

Fields

Richardson

Hopkinson

et al. 2016

Journal of Pain and Symptom Management

View full text Add to dashboard Cite

Context. Women taking aromatase inhibitors as treatment for breast cancer commonly experience joint pain and stiffness (aromatase inhibitoreassociated arthralgia [AIAA]), which can cause problems with adherence. There is evidence that exercise might be helpful, and Nordic walking could reduce joint pain compared to normal walking.Objectives. To determine the feasibility of a trial of Nordic walking as an exercise intervention for women with AIAA. Methods. A feasibility study was carried out in a sample of women with AIAA using a randomized control design. Women were randomized to exercise (six-week supervised group Nordic walking training once per week with an increasing independent element, followed by six weeks 4 Â 30 minutes/week independent Nordic walking); or enhanced usual care. Data were collected on recruitment, retention, exercise adherence, safety, and acceptability. The Brief Pain Inventory, GP Physical Activity Questionnaire, and biopsychosocial measures were completed at baseline, six and 12 weeks.Results. Forty of 159 eligible women were recruited and attrition was 10%. There was no increased lymphedema and no long-term or serious injury. Adherence was >90% for weekly supervised group Nordic walking, and during independent Nordic walking, >80% women managed one to two Nordic walking sessions per week. From baseline to study end point, overall activity levels increased and pain reduced in both the intervention and control groups.Conclusion. Our findings indicate that women with AIAA are prepared to take up Nordic walking, complete a six-week supervised course and maintain increased activity levels over a 12-week period with no adverse effects. J Pain Symptom Manage 2016;-:-e-. Ó

show abstract

Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer

Hershman

Unger

Greenlee

et al. 2018

JAMA

220

235

View full text Add to dashboard Cite

IMPORTANCE Musculoskeletal symptoms are the most common adverse effects of aromatase inhibitors and often result in therapy discontinuation. Small studies suggest that acupuncture may decrease aromatase inhibitor-related joint symptoms. OBJECTIVETo determine the effect of acupuncture in reducing aromatase inhibitor-related joint pain. DESIGN, SETTING, AND PATIENTS Randomized clinical trial conducted at 11 academic centers and clinical sites in the United States from March 2012 to February 2017 (final date of follow-up, September 5, 2017). Eligible patients were postmenopausal women with early-stage breast cancer who were taking an aromatase inhibitor and scored at least 3 on the Brief Pain Inventory Worst Pain (BPI-WP) item (score range, 0-10; higher scores indicate greater pain). INTERVENTIONSPatients were randomized 2:1:1 to the true acupuncture (n = 110), sham acupuncture (n = 59), or waitlist control (n = 57) group. True acupuncture and sham acupuncture protocols consisted of 12 acupuncture sessions over 6 weeks (2 sessions per week), followed by 1 session per week for 6 weeks. The waitlist control group did not receive any intervention. All participants were offered 10 acupuncture sessions to be used between weeks 24 and 52. MAIN OUTCOMES AND MEASURESThe primary end point was the 6-week BPI-WP score. Mean 6-week BPI-WP scores were compared by study group using linear regression, adjusted for baseline pain and stratification factors (clinically meaningful difference specified as 2 points). RESULTS Among 226 randomized patients (mean [SD] age, 60.7 [8.6] years; 88% white; mean [SD] baseline BPI-WP score, 6.6 [1.5]), 206 (91.1%) completed the trial. From baseline to 6 weeks, the mean observed BPI-WP score decreased by 2.05 points (reduced pain) in the true acupuncture group, by 1.07 points in the sham acupuncture group, and by 0.99 points in the waitlist control group. The adjusted difference for true acupuncture vs sham acupuncture was 0.92 points (95% CI, 0.20-1.65; P = .01) and for true acupuncture vs waitlist control was 0.96 points (95% CI, 0.24-1.67; P = .01). Patients in the true acupuncture group experienced more grade 1 bruising compared with patients in the sham acupuncture group (47% vs 25%; P = .01).CONCLUSIONS AND RELEVANCE Among postmenopausal women with early-stage breast cancer and aromatase inhibitor-related arthralgias, true acupuncture compared with sham acupuncture or with waitlist control resulted in a statistically significant reduction in joint pain at 6 weeks, although the observed improvement was of uncertain clinical importance.

show abstract

Randomized Exercise Trial of Aromatase Inhibitor–Induced Arthralgia in Breast Cancer Survivors

Abstract: Exercise led to improvement in AI-induced arthralgia in previously inactive breast cancer survivors.

Cited by 270 publications

References 30 publications

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

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

Nordic Walking as an Exercise Intervention to Reduce Pain in Women With Aromatase Inhibitor–Associated Arthralgia: A Feasibility Study

Effect of Acupuncture vs Sham Acupuncture or Waitlist Control on Joint Pain Related to Aromatase Inhibitors Among Women With Early-Stage Breast Cancer

Contact Info

Product

Resources

About