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Risk factors for joint symptoms in postmenopausal Japanese breast cancer patients treated with anastrozole: a prospective multicenter cohort study of patient-reported outcomes

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Abstract

Background

Endocrine treatment-related adverse events have a strong impact on patients’ quality of life and sometimes result in treatment discontinuation. Since joint symptoms are the most frequently recognized side effect of aromatase inhibitors, evaluation of associated risk factors may yield significant findings.

Patients and methods

A total of 391 postmenopausal Japanese women with estrogen receptor-positive breast cancer and treated with adjuvant anastrozole were enrolled from 28 centers for assessment of patient-reported outcomes (PROs) in this prospective cohort study (SAVS-JP, UMIN000002455). Patients completed the self-report questionnaire at baseline and after 3, 6, 9, and 12 months of treatment for evaluation of frequency of treatment-related joint symptoms (arthralgia, decrease in range of joint motion, and joint stiffness).

Results

We obtained PROs from 362 patients (92.6 %) at baseline and at one or more subsequent points. New or worsening from baseline of joint symptoms were reported by 260 patients (71.8 %). More than 90 % of the symptoms were mild or moderate and nearly 80 % had occurred by 6 months. Multivariate analysis showed that a short time span after menopause [odds ratio (OR) 0.95, 95 % confidence interval (CI) 0.90–0.99; P = 0.02] and adjuvant chemotherapy (OR 2.29, 95 % CI 1.06–4.95; P = 0.03) were significant independent risk factors for joint symptoms. No significant relationships between body mass index (BMI) and joint symptoms were identified. Eighteen patients discontinued treatment during the 1st year and eight of them reported joint symptoms.

Conclusion

Taking into consideration that PROs may yield higher prevalence rates than physician ratings for symptoms published in pivotal clinical trials, we found that a short time span after menopause and use of adjuvant chemotherapy, but not high BMI, were significantly associated with joint symptoms. These findings might prove useful for counseling before initiating treatment with adjuvant aromatase inhibitors in postmenopausal Japanese women.

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Author information

Authors and Affiliations

  1. Department of Surgery, Kansai Rosai Hospital, Inaba-so, 3-1-69, Amagasaki, Hyogo, 660-8511, Japan

    Chiyomi Egawa

  2. Department of Breast Surgery, Hyogo Cancer Center, Kitaoji-cho, 13-70, Akashi, Hyogo, 673-8558, Japan

    Kouichi Hirokaga & Shintaro Takao

  3. Department of Breast Surgery, Shinko Hospital, Wakinohama-cho, 1-4-47, Chuo-ku, Kobe, Hyogo, 651-0072, Japan

    Kazuhiko Yamagami

  4. Department of Surgery, Kohnan Hospital, Kamokogahara, 1-5-16, Higashinada-ku, Kobe, Hyogo, 658-0064, Japan

    Masaru Miyashita

  5. Department of Surgery, Itami City Hospital, Koyaike, 1-100, Itami, Hyogo, 664-8540, Japan

    Masashi Baba

  6. Rokko Island Hospital, Koyochonaka, 2-11, Higashinada-ku, Kobe, Hyogo, 658-0032, Japan

    Shigetoshi Ichii

  7. Department of Surgery, Hyogo Prefectural Nishinomiya Hospital, Rokutanji-cho, 13-9, Nishinomiya, Hyogo, 662-0918, Japan

    Muneharu Konishi

  8. Department of Surgery, Kobe City Medical Center West Hospital, Ichiban-cho, 2-4, Nagata-ku, Kobe, Hyogo, 653-0013, Japan

    Yuichiro Kikawa

  9. Department of Surgery, Kobe Kyodo Hospital, Kubo-cho, 2-4-7, Nagata-ku, Kobe, Hyogo, 653-0041, Japan

    Junya Minohata

  10. Nishi-kobe Medical Center, Kojidai, 5-7-1, Nishi-ku, Kobe, Hyogo, 651-2273, Japan

    Toshitaka Okuno

  11. Miyauchi Clinic, Mukonoso, 4-10-5, Amagasaki, Hyogo, 661-0035, Japan

    Keisuke Miyauchi

  12. Chayamachi Breast Clinic, Chayamachi, 3-1, Kita-ku, Osaka, Osaka, 530-0013, Japan

    Kazuyuki Wakita

  13. Hyogo Prefectural Tsukaguchi Hospital, Minamitsukaguchi-cho, 6-8-17, Amagasaki, Hyogo, 661-0012, Japan

    Hirofumi Suwa

  14. Hashimoto Clinic, Sumiyoshihommachi, 1-7-2, Higashinada-ku, Kobe, Hyogo, 658-0051, Japan

    Takashi Hashimoto

  15. Department of Surgery, Takarazuka Municipal Hospital, Kohama, 4-5-1, Takarazuka, Hyogo, 665-0827, Japan

    Masayuki Nishino

  16. Department of Surgery, Kinki Central Hospital, Kurumazuka, 3-1, Itami, Hyogo, 664-8533, Japan

    Takashi Matsumoto

  17. Kobe Century Memorial Hospital, Misaki-cho, 1-9-1, Hyogo-ku, Kobe, Hyogo, 652-0855, Japan

    Toshiharu Hidaka

  18. Kobe Urban Breast Clinic, Kumoidori, 4-1-6, Chuo-ku, Kobe, Hyogo, 651-0096, Japan

    Yutaka Konishi

  19. Department of Breast Surgery, Hyogo Prefectural Kakogawa Medical Center, Kanno-cho Kanno, 203, Kakogawa, Hyogo, 675-8555, Japan

    Yoko Sakoda

  20. Department of Surgery, Kuma Hospital, Shimoyamatedori, 8-2-35, Chuo-ku, Kobe, Hyogo, 650-0011, Japan

    Akihiro Miya

  21. Department of Breast and Endocrine Surgery, Meiwa Hospital, Agenaruo-cho, 4-31, Nishinomiya, Hyogo, 663-8186, Japan

    Masao Mitsunobu

  22. Nishikawa Clinic, Nishidaimotsu-cho, 12-41, Amagasaki, Hyogo, 660-0827, Japan

    Hidefumi Nishikawa

  23. Department of Breast and Endocrine Surgery, Kobe University School of Medicine, Kusunoki-cho, 7-5-2, Chuo-ku, Kobe, Hyogo, 650-0017, Japan

    Seishi Kono

  24. Kokufu Breast Clinic, Nakayamadera, 1-10-6, Takarazuka, Hyogo, 665-0861, Japan

    Ikuo Kokufu

  25. Sakita Clinic, Wajo-cho, 2-35-101, Nishinomiya, Hyogo, 662-0971, Japan

    Isao Sakita

  26. Kitatsuji Clinic, Nishitachibana-cho, 3-1-1, Amagasaki, Hyogo, 660-0054, Japan

    Koushiro Kitatsuji

  27. Kobe Adventist Hospital, Arinodai, 8-4-1, Kita-ku, Kobe, Hyogo, 651-1321, Japan

    Koushi Oh

  28. Division of Breast and Endocrine Surgery, Department of Surgery, Hyogo College of Medicine, Mukogawa-cho, 1-1, Nishinomiya, Hyogo, 663-8501, Japan

    Yasuo Miyoshi

Authors
  1. Chiyomi Egawa
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  2. Kouichi Hirokaga
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  3. Shintaro Takao
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  4. Kazuhiko Yamagami
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  5. Masaru Miyashita
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  6. Masashi Baba
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  7. Shigetoshi Ichii
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  8. Muneharu Konishi
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  9. Yuichiro Kikawa
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  10. Junya Minohata
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  11. Toshitaka Okuno
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  12. Keisuke Miyauchi
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  13. Kazuyuki Wakita
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  14. Hirofumi Suwa
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  15. Takashi Hashimoto
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  16. Masayuki Nishino
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  17. Takashi Matsumoto
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  18. Toshiharu Hidaka
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  19. Yutaka Konishi
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  20. Yoko Sakoda
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  21. Akihiro Miya
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  22. Masao Mitsunobu
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  23. Hidefumi Nishikawa
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  24. Seishi Kono
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  25. Ikuo Kokufu
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  26. Isao Sakita
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  27. Koushiro Kitatsuji
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  28. Koushi Oh
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  29. Yasuo Miyoshi
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Corresponding author

Correspondence to Yasuo Miyoshi.

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Funding source

This study was funded by the Hyogo College of Medicine.

Conflict of interest

Yasuo Miyoshi has received research funding and honoraria from Chugai Pharmaceutical Co., Ltd., AstraZeneca K.K., GlaxoSmithKline K.K., Novartis Pharma K.K., and Taiho Pharmaceutical Co., Ltd. All other authors of this manuscript have no conflict of interest.

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Egawa, C., Hirokaga, K., Takao, S. et al. Risk factors for joint symptoms in postmenopausal Japanese breast cancer patients treated with anastrozole: a prospective multicenter cohort study of patient-reported outcomes. Int J Clin Oncol 21, 262–269 (2016). https://doi.org/10.1007/s10147-015-0905-5

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  • DOI: https://doi.org/10.1007/s10147-015-0905-5

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