Influence Factor Of Aromatase Inhibitor-associated Arthralgia

Background：Aromatase inhibitors (AIs) are a standard of the adjuvant treatment ofhormone responsive carcinoma of the breast as demonstrated in a number of largeinternational phase III randomised trials. Aromatase inhibitor-associated arthralgia（AIA）was a somewhat unexpected side effect of this class of medicines and hasproven to be potentially problematic in clinical practice.Objective: This study identifies the risk factors of aromatase inhibitor-associatedarthralgia, for predicting the risk of AIA, and select appropriate therapeutic strategies toreduce the incidence ofAIA，thereby improving breast cancer-related outcomes.Methods: A total of105breast cancer patients with AIs monotherapy at department ofOncology, the Second Affiliated Hospital, Dalian Medical University from June2011toJune2013were reviewed. We evaluated the potential clinical factors for AIA, usingunivariate analysis (chi-square) and the multivariate logistic regression model. For theAIA patient, we evaluated the correlation analysis between the pain score andindependent factors, using the chi-square or Fisher’s exact test.Result: Among105patients,52patients (49.5%) experienced AIA symptoms.Approximately83%patients report AIA within the first6months. AIA occurs at amedian time of3months after take the medicine; AIA lasts for a median duration of6months. The most common symptom is: morning stiffness as well as the pain of hands,knees, hips, lower back and shoulder. The incidence of AIA: knee (56%), wrist/hand(42%), waist (33%), shoulder/back (32%), hip (27%), ankle/foot (27%), morning stiffness (15%), elbow (13%). Univariate analysis demonstrate that age(＜55y vs≥55y，χ2=10.367，P=0.002)、Her-2（Negative vs not explicitly vs positive，χ2=9.638，P=0.008）、Whether taking calcium D3(yes vs no, χ2=13.859, P=0.000),were significant for AIA.Multivariate analysis demonstrate that age (＜55y vs≥55y，OR0.378，95%CI：0.156-0.915，P=0.031)、Her-2（Negative vs not explicitly vs positive，OR0.598，95%CI：0.399-0.895，P=0.013）、Whether taking calcium D3(yes vs no, OR0.248，95%CI：0.099-0.621，P=0.003)，were independent associated factors to AIA. For AIA patients,univariate analysis showed that whether taking calcium D3(no vs yes, χ2=19.691, P=0.003) is correlated with the degree of pain score.Conclusion:Age <55years, Her-2negative, not taking calcium D3，are associated withthe high incidence of AIA in breast cancer patients. Prior use of calcium D3couldreduce pain scores.