Comparison of the clinical effectiveness of treatments for aromatase inhibitor-induced arthralgia in breast cancer patients: A systematic review with network meta-analysis

Kyeore Bae; Gillian Lamoury; Susan Carroll; Marita Morgia; Stephanie Lim; Sally Baron-Hay; In-Soo Shin; So-Jung Park; Byeongsang Oh

doi:10.1016/j.critrevonc.2022.103898

Comparison of the clinical effectiveness of treatments for aromatase inhibitor-induced arthralgia in breast cancer patients: A systematic review with network meta-analysis

Crit Rev Oncol Hematol. 2023 Jan:181:103898. doi: 10.1016/j.critrevonc.2022.103898. Epub 2022 Dec 16.

Authors

Kyeore Bae¹, Gillian Lamoury², Susan Carroll³, Marita Morgia⁴, Stephanie Lim⁵, Sally Baron-Hay⁶, In-Soo Shin⁷, So-Jung Park⁸, Byeongsang Oh⁹

Affiliations

¹ Integrative Cancer Center, Doban Hospital, Seoul, 03170, Republic of Korea; Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia. Electronic address: kyeorebae@gmail.com.
² Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 2006, Australia. Electronic address: Gillian.Lamoury@health.nsw.gov.au.
³ Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 2006, Australia. Electronic address: Susan.Carroll@health.nsw.gov.au.
⁴ Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia. Electronic address: Marita.Morgia@health.nsw.gov.au.
⁵ Medical Oncology Department, Macarthur Cancer Therapy Centre, Campbelltown, New South Wales, 2560, Australia; Western Sydney University, Campbelltown, New South Wales, 2560, Australia. Electronic address: Stephanie.Lim@health.nsw.gov.au.
⁶ Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 2006, Australia. Electronic address: sbaronha@med.usyd.edu.au.
⁷ Department of Graduate School of Education, Dongguk University, Seoul, 04620, Republic of Korea. Electronic address: 9065031@daum.net.
⁸ Department of Internal Medicine, Korean Medicine Hospital of Pusan National University, Yangsan, Gyeongnam, 50612, Republic of Korea. Electronic address: vivies@hanmail.net.
⁹ Northern Sydney Cancer Centre, Royal North Shore Hospital, St Leonards, Sydney, New South Wales, 2065, Australia; Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, 2006, Australia. Electronic address: byeong.oh@sydney.edu.au.

PMID: 36535489
DOI: 10.1016/j.critrevonc.2022.103898

Abstract

Aromatase inhibitor-induced arthralgia (AIA) contributes to poor adherence of aromatase inhibitor therapies in patients with breast cancer. A systematic review using network meta-analysis (NMA) was conducted to examine the clinical effectiveness of multiple therapies and rank probabilities for the management of AIA. Randomized controlled trials (RCTs) assessing treatments for AIA in postmenopausal women with stage 0-III hormone receptor-positive breast cancer were searched from inception to October 2021. The main NMA involved 1516 participants from 17 RCTs. Acupuncture was the highest ranked intervention to improve pain intensity followed by sham acupuncture, multicomponent herbal medicine, exercise, duloxetine, vitamin D, omega-3 fatty acids, physical therapy, testosterone, and inactive controls. Single natural products were inferior to controls. The current review provides new insights into the management of AIA in breast cancer survivors for increased survival and can be utilized to make evidence-based decisions regarding treatment.

Keywords: Aromatase inhibitor; Breast cancer; Network meta-analysis; Pain; Quality of life.

Publication types

Meta-Analysis
Systematic Review
Review

MeSH terms

Aromatase Inhibitors* / adverse effects
Arthralgia / chemically induced
Arthralgia / therapy
Breast Neoplasms* / chemically induced
Breast Neoplasms* / complications
Breast Neoplasms* / drug therapy
Female
Humans
Network Meta-Analysis
Treatment Outcome

Substances

Aromatase Inhibitors