Abstract
More than a third of breast cancer patients undergoing aromatase inhibitor (AI) treatment
report joint pain. We conducted a longitudinal study to characterize the course of
AI-induced joint pain and other symptoms and to identify potential predictors for
developing these symptoms. Patients were recruited before AI initiation. The Brief
Pain Inventory, M. D. Anderson Symptom Inventory, and a joint-pain questionnaire were
administered at baseline and then biweekly for 1 year. Analysis included logistic
regression, Cox models, and mixed-effects models. Of 47 patients assessed, 16 (34%)
reported joint pain at least once. Median time to first report of joint pain was 7
weeks (range, 1–38). Baseline pain was the only predictor for both incidence of joint
pain and time to first event. In the first 6 weeks, emergence of joint pain was associated
with increase in general pain, fatigue, disturbed sleep, hot flashes, vaginal dryness,
and decreased sexual activity. After week 6, having joint pain was associated with
increase in general pain and with persistently high fatigue. Having AI-associated
joint pain correlated with increase in or persistence of other symptoms likely related
to AI therapy. Further research is needed to validate predictors of AI-associated
symptoms.
Perspective
We demonstrate for the first time that AI-induced joint pain associates with development
of other symptoms and that pretreatment pain level is a potential, measurable predictor
of symptom development during treatment. Because baseline pain is easily assessed
with a brief questionnaire, it can be applied clinically with minimal patient burden.
Key words
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Article info
Publication history
Accepted:
November 26,
2012
Received in revised form:
November 19,
2012
Received:
August 29,
2012
Footnotes
Supported by grants from AstraZeneca and the Hawn Foundation and in part by the MD Anderson Cancer Center Support Grant CA016672 from the National Cancer Institute at the National Institutes of Health.
The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Cancer Institute or the National Institutes of Health.
The authors have declared no conflicts of interest.
Identification
Copyright
© 2013 American Pain Society. Published by Elsevier Inc. All rights reserved.
