School of Medicine and Public Health, University of Wisconsin, Madison, WI, USA.
Curr Oncol Rep. 2023 Jul;25(7):825-831. doi: 10.1007/s11912-023-01413-5. Epub 2023 Apr 13.
The study aims to review the literature regarding musculoskeletal complications of aromatase inhibitors and treatment options for these complications.
Aromatase inhibitors are common medications to treat hormone receptor-positive breast cancer in postmenopausal women and have been shown to improve survival and prevent disease recurrence. However, 20-60% patients stop treatment prematurely due to side effects. Side effects include joint stiffness and pain, tendonitis, tendon tears, muscle pain, and carpal tunnel syndrome known as aromatase inhibitor musculoskeletal syndrome (AIMSS) as well as bone loss. Proposed mechanisms of AIMSS include decreased estrogen levels, inflammation, and genetic factors. Switching aromatase inhibitors, exercise, non-steroidal anti-inflammatory medications, duloxetine, acupuncture, prednisone, and bisphosphonates are some treatment options for this syndrome and will be discussed in more detail in this review. Aromatase inhibitors are important in the treatment of hormone receptor-positive breast cancer in postmenopausal women. As we study the incidence of side effects of these medications including bone loss and AIMSS and determine the mechanisms of these symptoms and possible treatment options, we will decrease the incidence of patients discontinuing treatment prematurely and improve symptoms, quality of life, and survival in this patient population.
本研究旨在回顾关于芳香化酶抑制剂引起的肌肉骨骼并发症及其治疗选择的文献。
芳香化酶抑制剂是治疗绝经后女性激素受体阳性乳腺癌的常用药物，已被证明可改善生存并预防疾病复发。然而，20-60%的患者因副作用而提前停止治疗。副作用包括关节僵硬和疼痛、腱炎、肌腱撕裂、肌肉疼痛和腕管综合征，称为芳香化酶抑制剂肌肉骨骼综合征（AIMSS），以及骨质流失。AIMSS 的发病机制包括雌激素水平下降、炎症和遗传因素。该综述将详细讨论这种综合征的一些治疗选择，包括转换芳香化酶抑制剂、运动、非甾体类抗炎药、度洛西汀、针灸、泼尼松和双膦酸盐。芳香化酶抑制剂是绝经后女性激素受体阳性乳腺癌治疗的重要药物。随着我们研究这些药物的副作用（包括骨质流失和 AIMSS）的发生率以及确定这些症状的机制和可能的治疗选择，我们将降低患者提前停止治疗的发生率，并改善该患者人群的症状、生活质量和生存。
