Horimoto Yoshiya, Saito Mitsue, Kasumi Fujio
Department of Breast Oncology, Juntendo University School of Medicine, Tokyo, Japan.
Breast Care (Basel). 2009 Nov;4(5):319-323. doi: 10.1159/000236050. Epub 2009 Sep 21.
Arthralgia is common in post-menopausal women taking aromatase inhibitors. However, the underlying mechanism remains unknown.
We retrospectively examined the records of outpatients taking aromatase inhibitors to ascertain the frequency and severity of arthralgia.
Among 329 patients taking aromatase inhibitors (anastrozole in 239 and exemestane in 90 patients), 27% had arthralgia. There were 51 patients (16%) who switched from one aromatase inhibitor to another or quit aromatase inhibitor treatment. Arthralgia was the second most common reason for treatment changes in these 51 cases. In most cases, symptoms resolved after switching to a selective estrogen receptor modulator (SERM). We examined the relationships of arthralgia with other factors such as age, type of medication, prior treatments, and bone density. The arthralgia rate was significantly lower (p < 0.05) in patients with preceding endocrine therapy. No significant difference was detected between patients with versus patients without chemotherapy. Furthermore, there was no relationship between bone density and arthralgia.
Our observations suggest SERM treatment combined with an aromatase inhibitor to be perhaps the most practical clinical solution to the problem of arthralgia.
关节痛在服用芳香化酶抑制剂的绝经后女性中很常见。然而，其潜在机制仍不清楚。
我们回顾性检查了服用芳香化酶抑制剂的门诊患者记录，以确定关节痛的频率和严重程度。
在329例服用芳香化酶抑制剂的患者中（239例服用阿那曲唑，90例服用依西美坦），27%出现关节痛。有51例患者（16%）从一种芳香化酶抑制剂换用另一种或停用芳香化酶抑制剂治疗。关节痛是这51例患者治疗改变的第二常见原因。在大多数情况下，换用选择性雌激素受体调节剂（SERM）后症状缓解。我们研究了关节痛与年龄、药物类型、既往治疗及骨密度等其他因素的关系。既往接受过内分泌治疗的患者关节痛发生率显著较低（p<0.05）。化疗患者与未化疗患者之间未检测到显著差异。此外，骨密度与关节痛之间无关联。
我们的观察结果表明，SERM治疗联合芳香化酶抑制剂可能是解决关节痛问题最实用的临床方案。
