Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer

Purpose Aromatase inhibitors ( AIs) improve survival in postmenopausal women with hormone- sensitive breast cancer, but can cause joint pain and stiffness. The purpose of the current study was to evaluate the prevalence of and identify risk factors for AI-related joint symptoms. Patients and Methods We performed a cross-sectional survey of consecutive postmenopausal women receiving adjuvant AI therapy for early- stage hormone- sensitive breast cancer at an urban academic breast oncology clinic. Patients completed a 25- item self- administered questionnaire assessing the presence of joint symptoms that started or worsened after initiating AIs. Multivariate regression was used to compare those with AI- related arthralgia with those who did not report symptoms, adjusting for demographic and clinical factors. Results Of 200 patients who completed the survey, 94 ( 47%) reported having AI- related joint pain and 88 ( 44%) reported AI- related joint stiffness. In multiple logistic regression analysis, being overweight ( body mass index of 25 to 30 kg/m(2)) and prior tamoxifen therapy were inversely associated with AI- related joint symptoms. Patients who received taxane chemotherapy were more than four times more likely than other patients to have AI- related joint pain and stiffness ( odds ratio [OR] = 4.08, 95% CI, 1.58 to 10.57 and OR = 4.76; 95% CI, 1.84 to 12.28, respectively). Conclusion Our study suggests that AI-related joint symptoms are more prevalent than what has been described previously in clinical trials. The success of AI therapy depends on patients' ability to adhere to treatment recommendations; therefore, additional studies of interventions that may alleviate these symptoms are needed.