for Jean (and others) the long awaited tabulation/comparison of AI side effects

Lani · 09-19-2007, 06:38 AM

Patient-reported side effect AI
Studied
Incidence of clinically significant symptoms
at any time point during study period (%)
Odds ratio (OR) or
P-value for comparison
In favor of
AI Tamoxifen (or placebo as indicated)

Vasomotor symptoms
Hot flashes ANA 26.6 28.5 – ANA
EXE 46.0 44.7 OR = 1.10 TAM
LET 22.0 17.0 (PLA) P = 0.0002 PLA

Cold sweats ANA 7.7 9.1 – ANA
EXE 19.4 16.4 OR = 1.22 TAM

Night sweats ANA 17.8 21.3 – ANA
EXE 32.2 34.8 OR = 0.85 EXE
LET 17.0 14.0 (PLA) P = 0.047 PLA

Sleeping difficulties ANA 19.0 18.8 – –
EXE 34.6 34.5 OR = 1.12 TAM
LET 29.0 26.0 (PLA) P = 0.047 PLA

Neuropsychiatric symptoms
Lightheaded (dizzy) feeling ANA 3.1 5.4 – ANA
EXE 11.4 12.0 OR = 0.69 EXE

Headaches ANA 5.1 5.0 – TAM
EXE 18.3 15.0 OR = 1.38 TAM

Mood swings ANA 10.3 11.3 – ANA
EXE 20.8 19.8 OR = 1.02 –

Irritability ANA 8.7 9.1 – ANA
EXE 16.6 15.0 OR = 1.03 –

Lack of energy ANA 15.9 18.3 – ANA
EXE 37.7 34.1 OR = 1.17 TAM

Nervous feeling ANA 6.6 8.6 – ANA
EXE 19.7 19.8 OR = 0.93 EXE

Gastrointestinal symptoms
Weight gain ANA 22.6 20.6 – TAM
EXE 46.7 48.1 OR = 0.96 –
LET 21.0 22.0 (PLA) P = 0.45 –

Diarrhea ANA 3.1 1.3 – TAM
EXE 6.6 7.2 OR = 0.87 EXE

Bloated feeling ANA 10.4 10.9 – –
EXE 23.5 28.0 OR = 0.79 EXE

Nausea ANA 1.2 2.2 – ANA
EXE 5.2 4.8 OR = 1.21 TAM

Gynecologic symptoms
Vaginal discharge ANA 1.2 5.2 – ANA
EXE 7.6 17.1 OR = 0.25 EXE

Vaginal itching/irritation ANA 3.4 5.0 ANA
EXE 9.3 12.6 OR = 0.65 EXE

Vaginal dryness ANA 18.5 9.1 – TAM
EXE 23.5 26.3 OR = 1.14 TAM
LET 22.0 19.0 (PLA) P = 0.016 PLA

Pain or discomfort with
intercourse
ANA 17.3 8.1 – TAM
EXE 14.9 15.0 OR = 0.96 –
123... continued

Patient-reported side effect AI
Studied
Incidence of clinically significant symptoms at
any time point during study period (%)
Odds ratio (OR) or
P-value for comparison
In favor of
AI Tamoxifen (or placebo as indicated)

Lost interest in sex ANA 34.0 26.1 – TAM
EXE 41.2 45.4 OR = 1.03 –

Breast sensitivity/tenderness ANA 12.0 11.6 – TAM
EXE 19.4 22.5 OR = 1.16 TAM

Abbreviations: TAM = tamoxifen; ANA = anastrozole for 5 years in the ATAC trial [22]; EXE = exemestane for 2 years in the IES [24];
LET = letrozole for 2 years in the MA.17 trial [25]; PLA = placebo; OR = odds ratio. Note: letrozole also had significantly higher ‘‘Bodily
Pain’’
Breast Cancer Res Treat

Lani · 09-19-2007, 06:40 AM

1: Breast Cancer Res Treat. 2007 Sep 18; [Epub ahead of print]
Recognition and management of treatment-related side effects for breast cancer patients receiving adjuvant endocrine therapy.

Cella D, Fallowfield LJ.
Center on Outcomes, Research and Education, Northwestern University Feinberg School of Medicine, 1001 University Place, Suite 100, Evanston, IL, 60201, USA, d-cella@northwestern.edu.
In postmenopausal women with hormone receptor-positive early-stage breast cancer, the use of aromatase inhibitors (AIs) to suppress estrogen is associated with improved clinical outcomes compared with tamoxifen therapy. Women receiving such endocrine therapy may experience treatment-related side effects that negatively affect health-related quality of life (QoL) and adherence to therapy. In published clinical trials and in clinical practice, adverse events (AEs) constitute the main reason for nonadherence to endocrine treatment. Serious AEs are sometimes resolved by switching to a different agent, whereas other side effects can often be managed to allow patients to remain on therapy without sacrificing QoL. Across all adjuvant endocrine trials, regardless of the treatment received, vasomotor symptoms such as hot flashes are the most common side effects. Other frequently reported side effects, such as vaginal discharge, vaginal dryness, dyspareunia, and arthralgia, vary in prevalence between tamoxifen and AIs. Here we provide an overview of reported AEs of adjuvant endocrine therapy, focusing on those that are amenable to pharmacologic or nonpharmacologic management without treatment discontinuation. Also highlighted are specific management strategies that may improve patient QoL and thereby optimize adherence to therapy, which in turn might improve patient outcomes.
PMID: 17876703 [PubMed - as supplied by publisher]

Joanne S · 09-19-2007, 11:08 PM

Lani, Perhaps you can elaborate,
click below on Tamoxifen effectivess in and second post Oh I manged to see a current:

Joanne S Tamoxifen effectiveness in... Today, 12:55 AM

and

Joanne S Oh I manged to see a current... Today, 01:52 AM

Thanks,