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临床治疗中的依从性和关节痛:COMPACT 试验,评估辅助阿那曲唑治疗第一年的关节痛发生率和依从性。

COMPliance and Arthralgia in Clinical Therapy: the COMPACT trial, assessing the incidence of arthralgia, and compliance within the first year of adjuvant anastrozole therapy.

机构信息

Department of Gynecology, Endocrinology and Oncology, Philipps University of Marburg, Marburg.

出版信息

Ann Oncol. 2014 Feb;25(2):372-7. doi: 10.1093/annonc/mdt513. Epub 2013 Dec 18.

DOI:10.1093/annonc/mdt513
PMID:24355487
Abstract

BACKGROUND

This prospective study evaluated the relationship between arthralgia and compliance during the first year of adjuvant anastrozole therapy in postmenopausal women with hormone receptor-positive early breast cancer.

PATIENTS AND METHODS

COMPliance and Arthralgia in Clinical Therapy (COMPACT) was an open-label, multicenter, noninterventional study conducted in Germany. Patients had started adjuvant anastrozole 3-6 months before the study start. The primary end points were arthralgia, compliance, and the relationship between compliance and arthralgia, assessed at specific time points.

RESULTS

Overall, 1916 patients received upfront anastrozole. Mean arthralgia scores were increased from baseline at each visit up to 9 months. Compliance with anastrozole therapy gradually decreased over time from baseline to 9 months (P<0.001). At 9 months, investigators estimated that >95% of patients were compliant versus patient reports of <70%. There was a significant association between arthralgia mean scores and noncompliance at 6 months (P<0.0001), 9 months (P<0.0001), and overall (P<0.0001). Over time, new events or impairment of existing arthralgias were reported in 14% (3 months), 11% (6 months), and 9% (9 months) of patients.

CONCLUSION

Arthralgia is important in the clinical management of women with early breast cancer and may contribute to noncompliance and clinical outcomes.

CLINICALTRIALSGOV IDENTIFIER

NCT00857012.

摘要

背景

本前瞻性研究评估了激素受体阳性早期乳腺癌绝经后妇女接受辅助阿那曲唑治疗第一年时关节痛与依从性之间的关系。

患者和方法

COMPliance and Arthralgia in Clinical Therapy(COMPACT)是一项在德国进行的开放标签、多中心、非干预性研究。患者在研究开始前 3-6 个月开始接受辅助阿那曲唑治疗。主要终点是关节痛、依从性以及依从性与关节痛之间的关系,在特定时间点进行评估。

结果

总体而言,1916 例患者接受了阿那曲唑初始治疗。从基线开始,每个访视时的平均关节痛评分均升高,直至 9 个月。阿那曲唑治疗的依从性随着时间的推移从基线逐渐下降到 9 个月(P<0.001)。在 9 个月时,研究者估计超过 95%的患者是依从的,而患者报告的依从率<70%。在 6 个月(P<0.0001)、9 个月(P<0.0001)和总体(P<0.0001)时,关节痛平均评分与不依从性之间存在显著相关性。随着时间的推移,14%(3 个月)、11%(6 个月)和 9%(9 个月)的患者报告出现新的事件或原有关节痛加重。

结论

关节痛在早期乳腺癌妇女的临床管理中很重要,可能导致不依从和临床结局不佳。

临床试验注册号

NCT00857012。

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