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. 2011 Oct 10:11:436.
doi: 10.1186/1471-2407-11-436.

The time since last menstrual period is important as a clinical predictor for non-steroidal aromatase inhibitor-related arthralgia

Miyuki Kanematsu  1 , Masami Morimoto, Junko Honda, Taeko Nagao, Misako Nakagawa, Masako Takahashi, Akira Tangoku, Mitsunori Sasa
Affiliations

The time since last menstrual period is important as a clinical predictor for non-steroidal aromatase inhibitor-related arthralgia

Miyuki Kanematsu et al. BMC Cancer. .

Abstract

Background: The clinical predictors of aromatase inhibitor-related arthralgia (AIA), a drug-related adverse reaction of aromatase inhibitors (AIs), remain unclear.

Methods: AIA was prospectively surveyed every 4 months in 328 postmenopausal breast cancer patients administered a non-steroidal AI (anastrozole). Various clinicopathological parameters were recorded and analyzed (chi-square test, Fisher's exact test and logistic regression analysis).

Results: The mean observation period was 39.9 months. AIA manifested in 114 patients (34.8%), with peaks of onset at 4 (33.7%) and 8 months (11.4%) after starting AI administration. Some cases manifested even after 13 months. AIA tended to occur in younger patients (incidences of 46.3%, 37.4% and 28.0% for ages of < 55, 55-65 and > 65 years, respectively (p = 0.063)) and decreased significantly with the age at menarche (53.3%, 35.3% and 15.4% for < 12, 12-15 and > 15 years, respectively (p = 0.036)). The incidences were 45.1%, 46.3 and 25.1% for the time since the last menstrual period (LMP) < 5 years, 5-10 years and > 10 years, being significantly lower at > 10 years (p < 0.001). In logistic regression analysis, the AIA incidence was significantly lower in the time since LMP > 10-year group versus the < 5-year group (odds ratio 0.44, p = 0.002), but the age at menarche showed no association. AIA manifested significantly earlier (≤ 6 months) as the time since LMP became shorter (< 5 years).

Conclusion: AIA tends to manifest early after starting AI, but some cases show delayed onset. The incidence was significantly lower in patients with a duration of > 10 years since LMP. When the time since LMP was short, the onset of AIA was significantly earlier after starting AI administration.

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Figures

Figure 1
Figure 1
The time of onset of AIA showed peaks at 4 (33.7%) and 8 months (11.4%) after starting AI administration, and there was onset in a small number of patients even after more than 13 months.
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