Evaluation of Arthralgia Induced by Aromatase Inhibitor Therapy

Abstract

Purpose: In breast cancer treatment, aromatase inhibitors (AI) and tamoxifen (Tmx) are frequently used. In this study, the relationship between the hormonal therapy and arthralgia in women with breast cancer was studied.

Methods: Sixty-four patients of whom 32 taking AI and 32 taking Tmx were included in the study. VAS was used to determine the intensity of pain. Also five options Likert scale was applied to all patients to answer the question "what are your thoughts about the sources of your current pain?". As laboratory parameters, CBC, BUN creatinine, ALT, AST, alkaline phosphatase, calcium, CRP, ESR, ANA, RF, and estradiol levels of the patients were analyzed.

Results: The mean age of the AI group was 52.7 +/- 8.2 years old and in the Tmx group, it was 47.4 +/- 6.5 years old (p<0.05). According to Likert scale; the frequency of arthralgia attributed to drug was 43.8% in AI group and 0% in tamoxifen group (p<0.05). VAS of AI group (4.7 +/- 3.0) was higher than VAS of Tmx group (1.7 +/- 2.1) (p<0.05). Serum estradiol level of AI group (16.4 +/- 13.2 pg/ml) was found to be lower when compared to that of Tmx group (34.2 +/- 21.4 pg/ml) (p<0.05). There was no statistically significant differences between groups for other laboratory parameters (p>0.05, for each).

Conclusion: In our study, more frequent and severe arthralgia has been observed in patients under AI treatment when compared to tamoxifen. One of the causes that leads to arthralgia in patients using AI may be low levels of estradiol.