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Arthralgies, effets secondaires des inhibiteurs de l’aromatase: fréquence, signification et conséquences

Arthralgia, AI induced side events: incidence, feature and consequences

  • Synthèse / Review Article
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Oncologie

Abstract

After a decade of endocrine adjuvant treatment with AI (Aromatase inhibitors), it is documented that they are somewhat superior to tamoxifen, in postmenopausal women with hormone receptor-positive breast cancer. However, compared with tamoxifen, an elevated incidence of arthralgia (pain in one or more joints), has been observed during AI treatment, symptoms more important and problematic than anticipated. The potential mechanisms behind AI-induced arthralgia are not well understood, even if estrogen withdrawal may probably play a role. The frequency is not well-established within the population and clinical predictors of these related arthralgia remain unclear, but this adverse event may result in poor adherence to treatment; interventions to ameliorate are often not efficient and at least, patients and physicians can be dissuading from completing the full AI treatment. Patient educations about some management of arthralgia symptoms can helping patients adhere to AI treatment and improve breast cancer outcomes. For some authors, the occurrence of joint or vasomotor symptoms might be a predictor of treatment effectiveness and might be useful when reassuring patients who present with them, but nevertheless in reality, this opinion is insufficient to avoid adherence. The association between emergent musculoskeletal symptoms and improved outcomes have not been described as consistent in most of experiences.

Résumé

Après une décennie d’hormonothérapie adjuvante utilisant les AI, il apparaît que ceux-ci sont un peu supérieurs au tamoxifène chez la femme ménopausée avec tumeurs hormonosensibles. Cependant, en comparaison avec le tamoxifène, une fréquence élevée d’arthralgies (définies par des douleurs dans une ou plusieurs articulations) est apparue pendant le traitement par AI, symptomatologie plus préoccupante qu’attendue. Les mécanismes en cause dans ces arthralgies liées aux AI sont mal compris, non univoques, même si la carence en estrogène semble jouer un rôle. La fréquence n’est pas bien établie au sein de la population concernée, et les signes prédictifs pas évidents, mais cet effet secondaire peut être responsable d’une mauvaise adhésion au traitement; les interventions à visée d’amélioration sont souvent inefficaces et au total, patientes et médecins peuvent être tentés de ne pas terminer le traitement. L’éducation thérapeutique afin de mieux gérer certains signes articulaires peut aider les patients à poursuivre leur traitement et ainsi améliorer leur survie. Pour certains auteurs, l’apparition de signes climatériques ou articulaires peut être un signe d’efficacité du traitement, notion qui peut être utile pour rassurer les patientes qui les présentent, mais dans la réalité de terrain, cette notion n’est pas suffisante pour améliorer l’observance. L’association entre l’existence de signesmusculosquelettiques et l’amélioration du pronostic n’est pas retenue comme effective par la majorité des auteurs.

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Références

  1. Amir E, Seruga B, Niraula S (2011) Toxicity of adjuvant endocrine therapy in postmenopausal breast cancer patients: a systematic review and meta-analysis. J Natl Cancer Inst 103(17): 1299–1309

    Article  PubMed  CAS  Google Scholar 

  2. Azria D, Lamy PJ, Belkacemi Y, et al. (2006) Letrozole-induced arthralgia is not consistent with an autoimmune disease resembling Sjögren’s syndrome: Preliminary results of a multicentric prospective trial. Breast Cancer Res Treat 100: S25(Suppl 1; abstr 106)

    Google Scholar 

  3. Banning M (2012) Adherence to adjuvant therapy in post-menopausal breast cancer patients: a review Eur J Cancer Care 21(1): 10–19

    Article  CAS  Google Scholar 

  4. Barron TI, Connolly R, Bennett K, et al. (2007) Early discontinuation of tamoxifen: a lesson for oncologists. Cancer 109: 832–839

    Article  PubMed  CAS  Google Scholar 

  5. Baum M, Budzar AU, Cuzick J, et al. (2002) Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet 359: 2131–2139

    Article  PubMed  CAS  Google Scholar 

  6. Blencowe NS, Reichl C, Gahir J (2010) The use of Nolvadex® in the treatment of generic tamoxifen-associated small joint arthralgia. Breast 19(3): 243–245

    Article  PubMed  CAS  Google Scholar 

  7. Boccardo F, Rubagotti A (2007) Switching to aromatase inhibitors in early breast cancer Lancet 369: 533–535

    Article  PubMed  Google Scholar 

  8. Bower JE, Ganz PA, Irwin MR, et al. (2011) Inflammation and behaviour symptoms after breast cancer treatment: do fatigue, depression, and sleep disturbance share a common underlying mechanism? J Clin Oncol 29: 3517–3522

    Article  PubMed  Google Scholar 

  9. Briot K, Tubiana-Hulin M, Bastit L (2010) Effect of a switch of aromatase inhibitors on musculoskeletal symptoms in postmenopausal women with hormone-receptor positive breast cancer: the ATOLL (Articular Tolerance of Letrozole) study. Breast Cancer Res Treat 120: 127–134

    Article  PubMed  CAS  Google Scholar 

  10. Burstein HJ, Winer EP (2007) Aromatase inhibitors and arthralgias: a new frontier in symptom management for breast cancer survivors J Clin Oncol 25(25): 3797–3798

    Article  PubMed  Google Scholar 

  11. Burstein HJ (2007) Aromatase inhibitorassociated arthralgia syndrome. Breast 16(3): 223–234

    Article  PubMed  Google Scholar 

  12. Burstein HJ, Prestrud AA, Seidenfeld J, et al. (2010) American Society of Clinical Oncology Clinical Practice Guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol 28: 3784–3796

    Article  PubMed  Google Scholar 

  13. Buzdar A, Howell A, Cuzick J, et al. (2006) Comprehensive side-effect profile of anastrozole and tamoxifen as adjuvant treatment for early stage breast cancer: long-term safety analysis of the ATAC trial. Lancet Oncol 7: 633–643

    Article  PubMed  CAS  Google Scholar 

  14. Cecil RL, Archer BH (1925) Arthritis of the menopause. JAMA 84: 75–79

    Article  Google Scholar 

  15. Cella D, Fallowfield LJ, Barker P (2006) Quality of life of postmenopausal women in the ATAC trial after completion of 5 years adjuvant treatment for early breast cancer. Breast Cancer Res Treat 100: 273–284

    Article  PubMed  Google Scholar 

  16. Chlebowski RT, Geller ML (2006) Adherence to endocrine therapy for breast cancer. Oncology 71: 1–9

    PubMed  CAS  Google Scholar 

  17. Chlebowski RT (2009) Aromatase inhibitor-associated arthralgias. J Clin Oncol 27(30): 4932–4934

    Article  PubMed  Google Scholar 

  18. Cluze C, Rey D, Huiart L, et al. (2012) Adjuvant endocrine therapy with tamoxifen in young women with breast cancer: determinants of interruptions vary over time. Ann Oncol 23(4): 882–890

    Article  PubMed  CAS  Google Scholar 

  19. Cole SR, Stuart EA (2010) Generalizing evidence from randomized clinical trials to target populations: the ACTG 320 trial. Am J Epidemiol 172: 107–115

    Article  PubMed  Google Scholar 

  20. Coleman RE, Banks LM, Girgis SI, et al. (2007) Skeletal effects of exemestane on bone-mineral density, bone biomarkers, and fracture incidence in postmenopausal women with early breast cancer participating in the Intergroup Exemestane Study (IES): a randomised controlled study. Lancet Oncol 8: 119–127

    Article  PubMed  CAS  Google Scholar 

  21. Coleman RE, Bolten WW, Lansdown M, et al. (2008) Aromatase inhibitor-induced arthralgia: clinical experience and treatment recommendations. Cancer Treat Rev 34: 275–282

    Article  PubMed  CAS  Google Scholar 

  22. Coombes RC, Hall E, Gibson LJ, et al. (2004) A randomized trial of exemestane after two to three years of tamoxifen therapy in postmenopausal women with primary breast cancer. N Engl J Med 350: 1081–1092

    Article  PubMed  CAS  Google Scholar 

  23. Coombes RC, Kilburn LS, Snowdon CF, et al. (2007) Survival and safety of exemestane versus tamoxifen after 2–3 years’ tamoxifen treatment (Intergroup Exemestane Study): a randomised controlled trial. Lancet 369: 559–570

    Article  PubMed  CAS  Google Scholar 

  24. Crew KD, Greenlee H, Capodice J (2007) Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. J Clin Oncol 25(25): 3877–3883

    Article  PubMed  Google Scholar 

  25. Cuzick J, Forbes JF, Sestak I, et al. (2007) Long-term results of tamoxifen prophylaxis for breast cancer 96 month follow-up of the randomised IBIS-I trial. J Natl Cancer Inst 99: 272–282

    Article  PubMed  CAS  Google Scholar 

  26. Cuzick J, Sestak I, Cella D, Fallowfield L (2008) Treatment-emergent endocrine symptoms and the risk of breast cancer recurrence: a retrospective analysis of the ATAC trial. Lancet Oncol 9: 1143–1148

    Article  PubMed  CAS  Google Scholar 

  27. Cuzick J (2010) Controversies in design and interpretation of adjuvant clinical trials. Cancer Invest 28: 28–34

    Article  PubMed  CAS  Google Scholar 

  28. Davidson NE, Kensler TW (2011) “MAPping” the course of chemoprevention in breast cancer. N Engl J Med 364(25): 2463–2464

    Article  PubMed  CAS  Google Scholar 

  29. Dent S, DeVelentin T, Vanermeer L, et al. (2006) Long-term toxicities in women with early stage breast cancer treated with aromatase inhibitors: Data from a tertiary care center. Breast Cancer Res Treat 100: S190

    Google Scholar 

  30. Dent SF, Gaspo R, Kissner M (2011) Aromatase inhibitor therapy: toxicities and management strategies in the treatment of postmenopausal women with hormone-sensitive early breast cancer. Breast Cancer Res Treat 126: 295–310

    Article  PubMed  CAS  Google Scholar 

  31. Di Matteo MR, Lepper HS, Croghan TW (2000) Depression is a risk factor for non compliance with medical treatment: meta-analysis of the effects of anxiety and depression on patient adherence. Arch Intern Med. 160:2101–2107.

    Article  Google Scholar 

  32. Din OS, Dodwell D, Wakefield RJ (2010) Aromatase inhibitor-induced arthralgia in early breast cancer: what do we know and how can we find out more? Breast Cancer Res Treat 120: 525–538

    Article  PubMed  CAS  Google Scholar 

  33. Donnellan PP, Douglas SL, Cameron DA, et al. (2001) Aromatase inhibitors and arthralgia. J Clin Oncol 19(10): 2767

    PubMed  CAS  Google Scholar 

  34. Dugan SA, Powell LH, Kravitz HM (2006) Musculoskeletal pain and menopausal status. Clin J Pain 22: 325–331

    Article  PubMed  Google Scholar 

  35. Fallowfield L, Cella D, Cuzick J, et al. (2004) Quality of life of postmenopausal women in the arimidex, tamoxifen, alone or in combination (ATAC) adjuvant breast cancer trial. J Clin Oncol 22: 4261–4271

    Article  PubMed  CAS  Google Scholar 

  36. Fallowfield LJ (2008) Treatment-decision making in breast cancer: the patient-doctor relationship. Breast Cancer Res Treat 112: 5–13

    Article  PubMed  Google Scholar 

  37. Fallowfield LJ, Kilburn LS, Langridge C, et al. (2012) Long-term assessment of quality of life in the Intergroup Exemestane Study: 5 years post-randomisation. Br J Cancer 106(6): 1062–1067

    Article  PubMed  CAS  Google Scholar 

  38. Fellowes D, Fallowfield LJ, Saunders CM, et al. (2001) Tolerability of hormone therapies for breast cancer: how informative are documented symptom profiles in medical notes for “well-tolerated” treatments? Breast Cancer Res Treat 66: 73–81

    Article  PubMed  CAS  Google Scholar 

  39. Felson DT, Cummings SR (2005) Aromatase inhibitors and the syndrome of arthralgias with estrogen deprivation. Arthritis Rheum 52: 2594–2598

    Article  PubMed  CAS  Google Scholar 

  40. Felson DT (2008) Comparing the prevalence of rheumatic diseases in China with the rest of the world. Arthritis Res Ther 10(1): 106

    Article  PubMed  Google Scholar 

  41. Fraser J, Steele N, Zaman A (2011) Are patients in clinical trials representative of the general population? Dose intensity and toxicities associated with FE100C-D chemotherapy in a non-trial population of node positive breast cancer patients compared with PACS-01 trial group. Eur J Cancer SS 47: 215–220

    Article  CAS  Google Scholar 

  42. Goss PE, Ingle JN, Martino S, et al. (2003) A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med 349: 1793–1802

    Article  PubMed  CAS  Google Scholar 

  43. Goss PE, Ingle JN, Alés-Martínez JE, et al. (2011) Exemestane for breast-cancer prevention in postmenopausal women. N Engl J Med 364: 2381–2391

    Article  PubMed  CAS  Google Scholar 

  44. Grunfeld EA, Hunter MS, Sikka P, et al. (2005) Adherence beliefs among breast cancer patients taking tamoxifen. Patient Educ Couns 59(1): 97–102

    Article  PubMed  Google Scholar 

  45. Josse RG (2007) Roles for estrogen in bone loss and arthralgia during aromatase inhibitor treatment. Curr Opin Oncol 19S(Suppl1): S1–S8

    Article  Google Scholar 

  46. Henry NL, Giles JT, Stearns V (2008) Aromatase inhibitor associated musculoskeletal symptoms: etiology and strategies for management. Oncology 22: 1401–1408

    PubMed  Google Scholar 

  47. Henry NL, Giles JT, Ang D, et al. (2008) Prospective characterization of musculoskeletal symptoms in early stage breast cancer patients treated with aromatase inhibitors. Breast Cancer Res Treat 111: 365–372

    Article  PubMed  CAS  Google Scholar 

  48. Henry NL, Azzouz F, Desta Z, et al. (2012) Predictors of aromatase inhibitor discontinuation as a result of treatmentemergent symptoms in early-stage breast cancer. J Clin Oncol 30(9): 936–942

    Article  PubMed  CAS  Google Scholar 

  49. Hershman DL (2008) Getting a grip on aromatase inhibitor-associated arthralgias. J Clin Oncol 26(19): 3120–3122

    Article  PubMed  Google Scholar 

  50. Hjerl K, Andersen EW, Keiding N (2003) Depression as a prognostic factor for breast cancer mortality. Psychosomatics 44: 24–30

    Article  PubMed  Google Scholar 

  51. Ho SC, Chan SG, Yip YB (1999) Menopausal symptoms and symptom clustering in Chinese women. Maturitas 33: 219–227

    Article  PubMed  CAS  Google Scholar 

  52. Honda J, Kanematsu M, Nakagawa M (2011) Joint symptoms, aromatase inhibitor-related adverse reactions, are indirectly associated with decreased serum estradiol. Int J Surg Oncol 951260

  53. Huober JB, Cole BF, Wu J, et al. (2011) Symptoms of endocrine treatment and outcome: a retrospective analysis of the monotherapy arms of the BIG 1–98 trial. J Clin Oncol 29(Suppl): 522

    Google Scholar 

  54. Ingle JN, Schaid DJ, Goss PE, et al. (2010) Genome-wide associations and functional genomic studies of musculoskeletal adverse events in women receiving aromatase inhibitors. J Clin Oncol 28: 4674–4682

    Article  PubMed  CAS  Google Scholar 

  55. Laroche M, Borg S, Lassoued S (2007) Joint pain with AI: abnormal frequency of Sjôgren’s syndrome. J Rheumatol 34: 2259–2263

    PubMed  CAS  Google Scholar 

  56. Lesur A, Viguier JM (2001) La consultation de fin de traitement, le début d’une surveillance. La lettre du sénologue 11: 7–8

    Google Scholar 

  57. Liedke PE, Goss PE (2012) Aromatase inhibitors and musculoskeletal adverse events. Lancet Oncol 13(4): 333–334

    Article  PubMed  Google Scholar 

  58. Lintermans A, Neven P (2011) Pharmacology of arthralgia with estrogen deprivation. Steroids 76: 781–785

    Article  PubMed  CAS  Google Scholar 

  59. Mao JJ, Stricker C, Bruner D, et al. (2009) Patterns and risk factors associated with aromatase inhibitor-related arthralgia among breast cancer survivors. Cancer 115(16): 3631–3639

    Article  PubMed  CAS  Google Scholar 

  60. Mao JJ, Su HI, Feng R (2011) Association of functional polymorphisms in CYP19A1 with aromatase inhibitor associated arthralgia in breast cancer survivors. Breast Cancer Res 13: R8

    Article  PubMed  CAS  Google Scholar 

  61. McCowan C, Shearer J, Donnan PT, et al. (2008) Cohort study examining tamoxifen adherence and its relationship to mortality in women with breast cancer. Br J Cancer 99: 1763–1768

    Article  PubMed  CAS  Google Scholar 

  62. Menas P, Merkel D, Hui W (2012) Incidence and management of arthralgias in breast cancer patients treated with aromatase inhibitors in an outpatient oncology clinic. J Oncol Pharm Pract [Epub ahead of print]

  63. Mieog JS, Morden JP, Bliss JM (2012) Carpal tunnel syndrome and musculoskeletal symptoms in postmenopausal women with early breast cancer treated with exemestane or tamoxifen after 2–3 years of tamoxifen: a retrospective analysis of the Intergroup Exemestane Study s. Lancet Oncol 13(4): 420–432

    Article  PubMed  Google Scholar 

  64. Mortimer JE, Flatt SW, Parker BA (2008) Tamoxifen, hot flashes and recurrence in breast cancer. Breast Cancer Res Treat 108: 421–426

    Article  PubMed  CAS  Google Scholar 

  65. Murphy C, Hudis CA, Dickler MN (2008) Aromatase inhibitors and arthralgia: a growing pain? Oncology 22(12): 1424–1426

    PubMed  Google Scholar 

  66. Morales L, Pans S, Verschueren K (2008) Prospective study to assess short-term intra-articular and tenosynovial changes in the aromatase inhibitorassociated arthralgia syndrome. J Clin Oncol 26: 3147–3152.

    Article  PubMed  Google Scholar 

  67. Oberguggenberger A, Hubalek M, Sztankay M (2011) Is the toxicity of adjuvant aromatase inhibitor therapy underestimated? Complementary information from patient-reported outcomes (PROs). Breast Cancer Res Treat 128(2): 553–561

    Article  PubMed  CAS  Google Scholar 

  68. Ockene JK, Barad DH, Cochrane BB, et al. (2005) Symptom experience after discontinuing use of estrogen plus progestin. JAMA 294: 183–193

    Article  PubMed  CAS  Google Scholar 

  69. Offit K, Robson ME (2010) New pharmacogenomic paradigm in breast cancer treatment J Clin Oncol 28: 4665–4666

    Article  PubMed  Google Scholar 

  70. Otte JL, Flockhart D, Storniolo AM (2009) Comparison of subjective and objective hot flash measures over time among breast cancer survivors initiating aromataseinhibitor therapy. Menopause 16(4): 653–659

    Article  PubMed  Google Scholar 

  71. Partridge AH, Wang PS, Winer EP (2003) Nonadherence to adjuvant tamoxifen therapy in women with primary breast cancer. J Clin Oncol 21: 602–606

    Article  PubMed  CAS  Google Scholar 

  72. Powles TJ, Ashley S, Tidy A (2007) Twenty-year follow-up of the Royal Marsden randomised, double-blinded tamoxifen breast cancer prevention trial. J Natl Cancer Inst 99: 283–290

    Article  PubMed  CAS  Google Scholar 

  73. Presant CA, Bosserman L, Young T, et al. (2007) Aromatase inhibitor-associated arthralgia and/ or bone pain: frequency and characterization in non-clinical trial patients. Clin Breast Cancer 7(10): 775–778

    Article  PubMed  CAS  Google Scholar 

  74. Pritchard KI (2008) Endocrine symptoms to predict risk of recurrence? Lancet Oncol 9: 1117–1119

    Article  PubMed  Google Scholar 

  75. Ratain MJ (2011) Flushing oral oncology drugs down the toilet. J Clin Oncol 29(30): 3958–3959

    Article  PubMed  Google Scholar 

  76. Riley JL, Robinson ME, Wise EA, et al (1999) A meta-analytic review of pain perception across the menstrual cycle. Pain 81(3): 225–235

    Article  PubMed  Google Scholar 

  77. Ruddy KJ, Partridge AH (2009) Adherence with adjuvant hormonal therapy for breast cancer. Ann Oncol 20(3): 401–402

    Article  PubMed  CAS  Google Scholar 

  78. Ruhstaller T, von Moos R, Rufibach K, et al. 2009 Breast cancer patients on endocrine therapy reveal more symptoms when selfreporting than in pivotal trials: an outcome research study. Oncology 76: 142–148

    Article  PubMed  Google Scholar 

  79. Salant T, Ganschow PS, Olopade OI, et al. (2006) “Why take it if you don’t have anything?” Breast cancer risk perceptions and prevention choices at a public hospital. J Gen Intern Med 21: 779–785

    Article  PubMed  Google Scholar 

  80. Sestak I, Cuzick J, Sapunar F; ATAC Trialists’ Group (2008) Risk factors for joint symptoms in patients enrolled in the ATAC trial: a retrospective, exploratory analysis. Lancet Oncol 9(9): 866–872

    Article  PubMed  Google Scholar 

  81. Sestak I, Sapunar F, Cuzick J (2009) Aromatase inhibitor-induced carpal tunnel syndrome: results from the ATAC trial. J Clin Oncol 27(30): 4961–4965

    Article  PubMed  CAS  Google Scholar 

  82. Shumaker SA, Legault C, Rapp SR, et al. (2003) Estrogen plus progestin and the incidence of dementia and mild cognitive impairment in postmenopausal women: The Women’s Health Initiative Memory Study — a randomized controlled trial. JAMA 289: 2651–2662

    Article  PubMed  CAS  Google Scholar 

  83. Su HI, Sammel MD, Springer E (2010) Weight gain is associated with increased risk of hot flashes in breast cancer survivors on aromatase inhibitors Breast Cancer Res Treat 124: 205–211

    Article  PubMed  CAS  Google Scholar 

  84. Szoeke CE, Cicuttini FM, Guthrie JR, et al. (2008) The relationship of reports of aches and joint pains to the menopausal transition: a longitudinal study. Climacteric 11(1): 55–62

    Article  PubMed  CAS  Google Scholar 

  85. Tan AL, Emery P (2008) Role of oestrogen in the development of joint symptoms? Lancet Oncol 9(9): 817–818

    Article  PubMed  Google Scholar 

  86. Wang L, McLeod HL, Weinshilboum RM (2011) Genomics and Drug Response. N Engl J Med 364: 1144–1153

    Article  PubMed  CAS  Google Scholar 

  87. Waterhouse DM, Calzone KA, Mele C, et al. (1993) Adherence to oral tamoxifen: a comparison of patient self-report, pill counts, and microelectronic monitoring. J Clin Oncol 11: 1189–1197

    PubMed  CAS  Google Scholar 

  88. Whelan TJ, Goss PE, Ingle JN, et al. (2005) Assessment of quality of life in MA.17: a randomized, placebo-controlled trial of letrozole after 5 years of tamoxifen in postmenopausal women. J Clin Oncol 23: 6931–6940

    Article  PubMed  CAS  Google Scholar 

  89. Winer EP, Hudis C, Burstein HJ, et al. (2005) American Society of Clinical Oncology Technology Assessment on the use of aromatase inhibitors as adjuvant therapy for postmenopausal women with hormone receptor-positive breast cancer: status report 2004. J Clin Oncol 23: 619–629

    Article  PubMed  CAS  Google Scholar 

  90. Ziller V, Kalder M, Albert US (2009) Adherence to adjuvant endocrine therapy in postmenopausal women with breast cancer. Ann Oncol (3): 431–436

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    A. Lesur & C. Barlier

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Lesur, A., Barlier, C. Arthralgies, effets secondaires des inhibiteurs de l’aromatase: fréquence, signification et conséquences. Oncologie 14, 365–373 (2012). https://doi.org/10.1007/s10269-012-2180-7

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