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Prevalence of aromatase inhibitor-induced arthralgia in breast cancer: a systematic review and meta-analysis

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Abstract

Background

Although aromatase inhibitors have proven to be an effective treatment of hormone receptor-positive breast cancer in postmenopausal women, aromatase inhibitor-induced arthralgia (AIA) is an adverse event associated with low compliance with treatment. The aim of this literature study is to assess the prevalence of AIA and to provide an overview of significant predictors for the development of AIA.

Methods

A systematic review was conducted using PubMed, Cochrane Library and Web of Science. A meta-analysis was performed and heterogeneity has been investigated by moderator analyses. The meta-analysis was repeated with studies that were considered as best evidence, i.e. studies with an above-average score on the STROBE checklist.

Results

Twenty-one studies (13,177 participants) were included. Prevalence rates ranged from 0.200 to 0.737. Meta-analysis resulted in a pooled estimate of 0.459 (95% CI = [0.397–0.520) with a high heterogeneity (I 2 = 98%). Moderator analysis showed no differences regarding heterogeneity. Predictors for the development of AIA included a body mass index of 25–30 kg/m2 (OR = 0.33), taxane-based chemotherapy (OR = 4.08), stage III cancer (OR = 0.32) and a duration of menopause of 5–10 years (OR = 1.10) or >10 years (OR = 0.44–3.29) (An OR <1 indicates a predictor of lower risk of AIA).

Discussion

Despite the established benefits of AI, an important portion of the patients experiences AIA. More research is needed to investigate the efficacy of treatments such as exercise therapy for AIA.

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Authors and Affiliations

  1. Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium

    David Beckwée, Laurence Leysen, Kaipo Meuwis & Nele Adriaenssens

  2. Frailty in Ageing Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium

    David Beckwée

  3. Pain in Motion Research Group, Brussels, Belgium

    Laurence Leysen

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  1. David Beckwée
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Correspondence to David Beckwée.

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No funding was received to conduct this systematic review with meta-analysis.

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Appendix

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Table 5 Systematic literature search
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Table 6 STROBE-checklist
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Beckwée, D., Leysen, L., Meuwis, K. et al. Prevalence of aromatase inhibitor-induced arthralgia in breast cancer: a systematic review and meta-analysis. Support Care Cancer 25, 1673–1686 (2017). https://doi.org/10.1007/s00520-017-3613-z

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