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.

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