Abstract
11525 Background: The frequency of aromatase inhibitor (AI)-associated arthralgia is reported to be between 5–47% among various adjuvant studies. We aimed to investigate the prevalence and pathogenesis of AI associated arthralgia in patients with breast cancer. Methods: Fifty-three postmenopausal women with hormone receptor-positive breast cancer receiving adjuvant AI treatment were involved. Musculoskeletal symptoms were assessed by using Breast Cancer Prevention Trial (BCPT) symptom scales. Serum anti-nuclear antibody (ANA), anti-DNA antibody, erythrocyte sedimentation rate, C reactive protein, anti-cyclic citrullinated peptide antibodies (anti-CCP), rheumatoid factor (RF) levels were measured. Articular/periarticular ultrasonogram was performed for involved joints and electromyogram (EMG) of upper and lower extremities was performed for neuropathy. Results: Median age of the patients was 57 and median duration of AI use was 12 months. Thirty patients were receiving anastrozole, 22 receiving letrozole and one exemestane. 21 patients (39.6%) had AI- associated new-onset or worsening arthralgia. Most frequently involved joints were knee (67%), small joints of the hand (57%) and ankle (38.9%) joints. 26.4 % of the patients had ANA positivity (titer 1/80–1/160, homogenous or speckled pattern), 5.7% had anti-DNA positivity, 5.7% had anti-CCP positivity, 35.8% had RF positivity, 40% had osteoporosis, 57% had effusion in the effected joints, 72% had EMG findings consistent with carpal tunnel syndrome. The only differences between the patients with and without arthralgia were ANA and anti-DNA positivity rates; 40% vs. 19% for ANA, p=0.1, and 14% vs. 0% for anti-DNA, p=0.055, respectively. Conclusions: A significant fraction of patients using AIs experiences arthralgia. This study showed that an autoimmune process may be responsible for arthralgia in at least a proportion of the patients. No significant financial relationships to disclose.
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