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Time course of arthralgia among women initiating aromatase inhibitor therapy and a postmenopausal comparison group in a prospective cohort
Author(s) -
Castel Liana D.,
Hartmann Katherine E.,
Mayer Ingrid A.,
Saville Benjamin R.,
Alvarez JoAnn,
Boomershine Chad S.,
Abramson Vandana G.,
Chakravarthy A. Bapsi,
Friedman Debra L.,
Cella David F.
Publication year - 2013
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/cncr.28016
Subject(s) - medicine , aromatase inhibitor , joint pain , physical therapy , prospective cohort study , breast cancer , confidence interval , comorbidity , shoulders , cohort , cancer , surgery , aromatase
BACKGROUND More than 80,000 postmenopausal breast cancer patients in the United States each year are estimated to begin a 5‐year course of aromatase inhibitors (AIs) to prevent recurrence. AI‐related arthralgia (joint pain and/or stiffness) may contribute to nonadherence, but longitudinal data are needed on arthralgia risk factors, trajectories, and background in postmenopause. This study sought to describe 1‐year arthralgia trajectories and baseline covariates among patients with AI and a postmenopausal comparison group. METHODS Patients initiating AIs (n = 91) were surveyed at the time of AI initiation and at 6 repeated assessments over 1 year. A comparison group of postmenopausal women without breast cancer (n = 177) completed concomitantly timed surveys. Numeric rating scales (0–10) were used to measure pain in 8 joint pair groups (bilateral fingers, wrists, elbows, shoulders, hips, knees, ankles, and toes). Poisson regression models were used to analyze arthralgia trajectories and risk factors. RESULTS By week 6, the AI‐initiating group had more severe arthralgia than did the comparison group (ratio of means = 1.8, 95% confidence interval = 1.24‐2.7, P = .002), adjusting for baseline characteristics. Arthralgia then worsened further over 1 year in the AI group. Menopausal symptom severity and existing joint‐related comorbidity at baseline among women initiating AI were associated with more severe arthralgia over time. CONCLUSIONS Patients initiating AI should be told about the timing of arthralgia over the first year of therapy, and advised that it does not appear to resolve over the course of a year. Menopausal symptoms and joint‐related comorbidity at AI initiation can help identify patients at risk for developing AI‐related arthralgia. Cancer 2013;119:2375–2382 . © 2013 American Cancer Society .