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Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors.

ABSTRACT: Arthralgia occurs in up to 50% of breast cancer survivors treated with aromatase inhibitors (AIs) and is the most common reason for poor AI adherence. We conducted, in 121 breast cancer survivors receiving an AI and reporting arthralgia, a yearlong randomized trial of the impact of exercise versus usual care on arthralgia severity.Eligibility criteria included receiving an AI for at least 6 months, reporting ? 3 of 10 for worst joint pain on the Brief Pain Inventory (BPI), and reporting < 90 minutes per week of aerobic exercise and no strength training. Participants were randomly assigned to exercise (150 minutes per week of aerobic exercise and supervised strength training twice per week) or usual care. The BPI, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were completed at baseline and at 3, 6, 9, and 12 months. Intervention effects were evaluated using mixed-model repeated measures analysis, with change at 12 months as the primary end point.Over 12 months, women randomly assigned to exercise (n = 61) attended 70% (± standard deviation [SD], 28%) of resistance training sessions and increased their exercise by 159 (± SD, 136) minutes per week. Worst joint pain scores decreased by 1.6 points (29%) at 12 months among women randomly assigned to exercise versus a 0.2-point increase (3%) among those receiving usual care (n = 60; P < .001). Pain severity and interference, as well as DASH and WOMAC pain scores, also decreased significantly at 12 months in women randomly assigned to exercise, compared with increases for those receiving usual care (all P < .001).Exercise led to improvement in AI-induced arthralgia in previously inactive breast cancer survivors.

SUBMITTER: Irwin ML

PROVIDER: S-EPMC4372849 | biostudies-literature | 2015 Apr

REPOSITORIES: biostudies-literature

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Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors.

Irwin Melinda L ML Cartmel Brenda B Gross Cary P CP Ercolano Elizabeth E Li Fangyong F Yao Xiaopan X Fiellin Martha M Capozza Scott S Rothbard Marianna M Zhou Yang Y Harrigan Maura M Sanft Tara T Schmitz Kathryn K Neogi Tuhina T Hershman Dawn D Ligibel Jennifer J

Journal of clinical oncology : official journal of the American Society of Clinical Oncology 20141201 10

<h4>Purpose</h4>Arthralgia occurs in up to 50% of breast cancer survivors treated with aromatase inhibitors (AIs) and is the most common reason for poor AI adherence. We conducted, in 121 breast cancer survivors receiving an AI and reporting arthralgia, a yearlong randomized trial of the impact of exercise versus usual care on arthralgia severity.<h4>Patients and methods</h4>Eligibility criteria included receiving an AI for at least 6 months, reporting ≥ 3 of 10 for worst joint pain on the Brief ...[more]

PMID: 25452437

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Project description:In postmenopausal women diagnosed with breast cancer (BC), most BC tumors are hormone receptor positive and guidelines recommend adjuvant endocrine therapy that includes an aromatase inhibitor (AI). This study investigates the impact of a 6-week, home-based, self-directed walking program on the commonly reported side effect of AI-associated arthralgia (AIAA).In this phase II trial, consented BC patients were randomized to walking Intervention (n?=?31) or Wait List Control (WLC; n?=?31). Eligibility criteria included: stage 0-III BC, on AI for at least 4 weeks, ?3 on a 5-point scale inquiring about joint symptom intensity "at its worst," and exercising ?150 minutes per week. Outcomes were self-reported joint symptoms and psychosocial measures. Analyses comparing Intervention and WLC groups were conducted on an intention-to-treat basis to assess intervention impact at 6 weeks (postintervention) and at 6-months follow-up. Adjusted means were calculated to assess differences in two groups.In our final sample (n?=?62), mean age was 64 years, 74% were white, and 63% had a body mass index of 30 or higher. At postintervention, Intervention group participants reported significantly increased walking minutes per week, reduced stiffness, less difficulty with activities of daily living (ADL), and less perceived helplessness in managing joint symptoms. At 6-months follow-up (postwalking period in both Intervention and WLC), walking minutes per week had decreased significantly; however, improvements in stiffness and difficulty with ADLs were maintained.This study adds to the growing evidence base suggesting exercise as a safe alternative or adjunct to medications for the management of AIAA.Breast cancer survivors whose adjuvant endocrine treatment includes an aromatase inhibitor (AI) often experience the side effect of AI-associated arthralgia (AIAA). This study investigates the impact of a 6-week, home-based, self-directed walking program in the management of AIAA. Compared with Wait List Control, women in the Intervention group reported significantly increased walking minutes per week, reduced stiffness, less difficulty with activities of daily living, and less perceived helplessness in managing joint symptoms. This study adds to the growing evidence base suggesting exercise as a safe alternative or adjunct to medications for the management of AIAA.

Dataset Information

Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors.

Publications

Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors.

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