Differential Analysis Of Adverse Reactions Between Steroidal And Non-steroidal Aromatase Inhibitors In Adjuvant Endocrine Therapy For Breast Cancer

Objective: Objective To explore the clinical adverse reactions of steroid and non-steroid AI drugs to HR+ postmenopausal breast cancer patients,so as to provide theoretical basis for rational clinical drug use and guide rational clinical drug use.Methods: Through the digital medical record system of the Affiliated Hospital of Qinghai University,through retrospective research methods,according to the results of immunohistochemistry of patients,and according to the criteria of admission and exclusion,128 HR patients who took steroidal and non-steroidal aromatase inhibitors for adjuvant endocrine therapy in our hospital from 2017 to 2021 were selected positive postmenopausal breast cancer patients.According to the mechanism of drug action,they were divided into steroid group(exemestane)and non-steroid group(letrozole,anastrozole group).The liver function indexes of the points were compared,and the related statistical analysis was finally carried out.Results:1.Compared with the letrozole and anastrozole groups,the exemestane group had a lower incidence of adverse events such as dyslipidemia and osteoporosis,and a higher incidence of abnormal liver function biochemical indicators,and the differences were statistically significant(P<0.05).2.The liver function index alanine transaminase(ALT)in the exemestane group was increased 12 months after taking the drug(P=0.012),and increased from the mean(21.98±6.99)to(27.61±13.38),the difference was statistically significant.There was no significant difference between before taking the medicine and 6 months after taking the medicine,and 6 months after taking the medicine and 12 months after taking the medicine.The level of serum total bilirubin(TBIL)index 12 months after taking the medicine was significantly higher than that before taking the medicine and 6 months after taking the medicine(P<0.001).increased to(13.00±4.79),and increased from the mean(13.00±4.79)to(14.03±5.30)6 months after taking the medicine compared to 12 months after taking the medicine.The TBIL index 6 months after taking the medicine was also significantly higher than that before taking the medicine(P<0.001),and the difference was statistically significant.The level of aspartate aminotransferase(AST)increased from the mean(22.88±4.80)to(28.92±12.47)12 months after taking the drug,(P<0.001)the difference was Statistical significance;there is no significant difference between before and 6 months after taking medicine,and 6 months after taking medicine and 12 months after taking medicine.There was no significant difference in the levels of ALT,TBIL,ALP,GGT and other liver function indexes before taking the medicine,6 months after taking the medicine and 12 months after taking the medicine(P>0.05).3.The levels of AST indexes in the letrozole and anastrozole groups 6 months after taking the medicine were significantly higher than those before taking the medicine(P=0.019),which increased from the mean(21.53±5.17)to(24.27±6.75),(P<0.05)are significant differences.There was no significant difference between before taking the medicine and 12 months after taking the medicine,and 6 months after taking the medicine and 12 months after taking the medicine.There was no significant difference in the levels of ALT,TBIL,ALP,GGT and other liver function indexes before taking the medicine,6 months after taking the medicine and 12 months after taking the medicine(P>0.05).4.The levels of ALT and AST in the exemestane group were higher than those in the letrozole and anastrozole groups at 12 months after taking the drug,and the difference was statistically significant(P<0.05).There were no significant differences in the levels of TBIL,ALP,GGT and other indicators between the two groups at 6 months and 12months after taking the medicine.Conclusion:1.Both steroidal and non-steroidal aromatase inhibitors can significantly increase the risk of adverse reactions such as dyslipidemia,osteoporosis,and abnormal biochemical indicators of liver function.2.Compared with letrozole and anastrozole groups,patients taking oral exemestane have less adverse reactions such as osteoporosis and dyslipidemia,and patients taking letrozole and anastrozole have less abnormal liver function biochemical indicators.3.For HR+ postmenopausal breast cancer patients,the non-steroidal drugs letrozole and anastrozole for oral endocrine therapy have less effect on early liver function than the steroidal drug exemestane.