Aromatase inhibitors and risk of arthritis and carpal tunnel syndrome among taiwanese women with breast cancer: A nationwide claims data analysis

Hsu Chih Chien, Yea Huei Kao Yang, C. Kent Kwoh, Pavani Chalasani, Debbie L. Wilson, Wei Hsuan Lo-Ciganic

Research output: Contribution to journalArticlepeer-review

5 Scopus citations

Abstract

Tamoxifen or aromatase inhibitor (AI) therapy may prevent breast cancer recurrence, however, adverse effects may lead to treatment discontinuation. Evidence regarding the occurrence of AI-associated musculoskeletal problems among Asians is scarce. We identified women with breast cancer-initiating tamoxifen or AIs from the Taiwan National Health Insurance Research Database (2007–2012). Using multivariable cause-specific hazard models, we examined the association between endocrine therapy and the risk of any arthritis and carpal tunnel syndrome, adjusting for age, prior cancer treatment, and other health status factors. Among 32,055 eligible women with breast cancer (mean age = 52.6 ± 11.5 years), 87.4% initiated tamoxifen, 3.9% initiated anastrozole, 8.0% initiated letrozole, and 0.7% initiated exemestane. AI users had a higher 1-year cumulative incidence for any arthritis (13.0% vs. 8.2%, p < 0.0001) and carpal tunnel syndrome (1.4% vs. 0.8%, p = 0.008). Compared to tamoxifen users, AI users had a higher risk of any arthritis [adjusted hazard ratio (aHR) = 1.21, 95%CI = 1.09–1.34] and carpal tunnel syndrome (aHR = 1.68, 95%CI = 1.22–2.32). No significant difference was observed in the risks of any arthritis and carpal tunnel syndrome across different AIs. Taxane use was not associated with any arthritis (aHR = 0.92, 95%CI = 0.81–1.05) or carpal tunnel syndrome (aHR = 0.97, 95%CI = 0.67–1.40) compared to other chemotherapies. Taiwanese women with breast cancer-initiating AIs had an increased risk of arthritis and carpal tunnel syndrome compared to those who initiated tamoxifen.

Original languageEnglish (US)
Article number566
JournalJournal of Clinical Medicine
Volume9
Issue number2
DOIs
StatePublished - Feb 2020

Keywords

  • Aromatase inhibitors
  • Arthralgia
  • Arthritis
  • Asian women
  • Breast cancer
  • Carpal tunnel syndrome
  • Endocrine therapy
  • Musculoskeletal problems
  • Taiwanese women
  • Taxane-based chemotherapy

ASJC Scopus subject areas

  • Medicine(all)

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