Marked improvement of the aromatase induced arthralgia syndrome following treatment with dextroamphetamine sulfate

D.L Check,J.H Check,M.P Dougherty

doi:10.12891/ceog4707.2019

Abstract

Purpose: To evaluate a novel treatment for aromatase induced arteralgia (AIA) syndrome. Materials and Methods: A woman already treated with dextroamphetamine sulfate for many years for a form of fibromyalgia developed AIA after 15 months of taking letrozole following mastectomy for breast cancer. Though she had already been taking dextroamphetamine sulfate 30mg extended release capsules for 25 years for other issues, her dosage was increased to 45mg. Results: Within a short length of time, the AIA manifesting as severe bilateral shoulder pain markedly improved. Conclusions: About 20% of women stop aromatase inhibitor therapy before the ideal 5 year time period because of bone pain and arthralgia. Sympathomimetic therapy should be considered. Hopefully this case will stimulate a larger prospective series. Content: Increasing the dosage of dextroamphetamine sulfate improved the pain from aromatase-induced arthralgia manifesting with severe bilateral shoulder pain.

Highlights

Recent studies have concluded that aromatase inhibitors are the most effective adjuvant anti-hormone therapy for post-menopausal women with estrogen receptor positive breast cancer [1]
About 50% of these women who are treated with aromatase inhibitors complain of significant joint pain which has been termed aromatase inhibitor-induced arthralgia (AIA) syndrome [2-4]
The pain can be so bothersome that 13-22% will stop the aromatase inhibitors before the five-year recommended time [4, 5]

Summary

Case Report

Summary Purpose: To evaluate a novel treatment for aromatase induced arteralgia (AIA) syndrome. Materials and Methods: A woman already treated with dextroamphetamine sulfate for many years for a form of fibromyalgia developed AIA after 15 months of taking letrozole following mastectomy for breast cancer. Though she had already been taking dextroamphetamine sulfate 30mg extended release capsules for 25 years for other issues, her dosage was increased to 45mg. Results: Within a short length of time, the AIA manifesting as severe bilateral shoulder pain markedly improved. Content: Increasing the dosage of dextroamphetamine sulfate improved the pain from aromatase-induced arthralgia manifesting with severe bilateral shoulder pain

Findings

Introduction

Discussion