new trial proposed--diuretics for AI induced arthralgias (aches and pains)

Lani · 04-28-2010, 06:48 AM

based on retrospective study of relatively small numbers of patients--comments anyone?

Breast. 2010 Apr 23. [Epub ahead of print]
New views on treatment of aromatase inhibitors induced arthralgia.
Xepapadakis G, Ntasiou P, Koronarchis D, Koufoudakis D, Panousis D, Grosomanidis D, Venizelos V, Georgiadis S.

Iaso General Hospital, 264 Mesogion Ave, Holargos, 15562 Athens, Attica, Greece.
Abstract
BACKGROUND: Aromatase Inhibitor (AI) induced arthralgia is one of the most frequent side effects in breast cancer hormonal therapy, which may become severe in some cases affecting patients' quality of life. The purpose of this study is to investigate alternative treatment of arthralgia, as current treatment options may often prove to be inadequate. MATERIAL-METHODS: According to Morales et al, AI-associated arthralgia syndrome is characterized by tenosynovial changes in MRI, including fluid in tendon sheaths and joints. Initially, furosemide (20 mg per two days) was prescribed by our team, in order to minimize peripheral edema in women receiving aromatase inhibitors. The data collected demonstrated that 16 out of 18 patients had benefited from the addition of a diuretic agent in their adjuvant AI treatment as far as AI induced arthralgia is concerned as well. In this retrospective study, data from 288 women receiving an AI for non-metastatic breast cancer are analyzed in order to define whether chronic diuretic therapy could affect the impact of arthralgia on those patients. RESULTS: 42/288 Patients were receiving chronic diuretic therapy for heart disease or hypertension (Group A), while 246/288 patients had never received any diuretic medication (Group B). At 43.03 months of mean follow up, in Group A arthralgia was developed in 3/42 patients (6.97%) as opposed to 39/246 patients in Group B (15.85%) -p value: 0.01. Other parameters that could affect the impact of arthralgia in both Groups are also analyzed and taken under consideration. CONCLUSION: Despite the low number of patients and the retrospective nature of the study, there was a clear trend to a lower incidence of arthralgia in patients receiving chronic diuretic therapy. We believe that based on this hypothesis generating study further research should be done to assess the value of diuretic agents in the treatment of AI-associated arthralgia. Copyright © 2010. Published by Elsevier Ltd.

PMID: 20418100

TSund · 05-03-2010, 04:03 PM

Interesting Lani, considering the misery that AI's have caused some women. Ruth's doing pretty well so far save some stiffness in her knees.

sassy · 05-09-2010, 03:49 PM

YES

I'm happy to see this info. I have been on Lasix for precisely this reason for several years and it has reduced my symptoms by at least 50%. I have mentioned this on the board a few times and have not found anyone else who has taken this approach.

Believe me, it works.

TSund · 05-10-2010, 06:38 AM

Sassy,

I am happy to see your reply! How did you get going early on this...was your onc on top of this?

Also, what dosage of lasix do you take and are there any side effects from the lasix?

Thanks very much

Terri

sassy · 05-10-2010, 06:27 PM

Hey Terri,

It was actually my GP/PA who decided to try the Lasix. She is a very good friend and was determined to help me find some relief from side effects. She knew joint pain was very often caused by edema, so thought Lasix was worth a try. In just a few days I began to feel the difference.

I take 40mg per day and we are thinking of lowering that to 20mg per day now that I am no longer taking Lupron in addition to the AI. As far as side effects, other than having to run to the potty every 45 minutes the first few hours of the day!, I just have to keep check on my potassium. I drink a least a glass of OJ and have a banana each day and have not had any issues.

As best I know, there would be little concern in at least trying the Lasix. It made a world of difference for me.

caya · 05-10-2010, 07:07 PM

I have been on a diuretic for about 25 years - for swelling/water retention while menstruating, now for the swelling/water retention since chemo/Herception/Tamox/Femara. It's a very old diuretic called chlorthalidone, 50mg/day. I wanted to switch to Lasix, but I am allergic to sulpha drugs and although Lasix is not a sulpha drug, there have been some reported cases of bad reactions from people like me when they take it.
Any other suggestions?

all the best
caya

TSund · 05-11-2010, 04:38 PM

Caya,

Are you having trouble with aches and pains from the AI even with your old diuretic? I guess if you've been on it for a long time you don't know if they would be worse without it...

sassy · 05-11-2010, 06:48 PM

Caya,

I too am allergic to sulpha drugs and penicillin and have not had any adverse side effects with Lasix.

Rich66 · 05-13-2010, 10:50 AM

I wonder if there is a relationship between inflammation and edema. Maybe the inflammation triggers accumulation of fluids?

caya · 05-13-2010, 11:08 AM

Sassy,

Thanks for the info - I will bring this up with my GP when I see her next week. I think it's worth a try.

all the best
caya

tricia keegan · 05-13-2010, 02:42 PM

I'm very interested in seeing more comments about this as I've been feeling like an eighty year old rather than fifty for the past four years. I'm happy to do that if it keeps the cancer at bay but would love to find something to help with these joint/bone aches other than chondroitn/glucosamine which my onc suggested and don't work too well.
Thanks for the info Lani!