HER2 Support Group Forums - View Single Post - Joint symptoms and other adverse effects of AIs (and a comparison)from SABCS

Lani · 12-22-2006, 11:40 AM

Another poster presented findings from an online patient survey carried out by the US advocacy group Breast Cancer Action (BCA). The survey, launched in August 2005, listed 38 adverse events associated with aromatase inhibitors (compiled from FDA-approved product labeling) and also asked whether respondents experienced any other unlisted adverse effects.

Of 612 women who responded, nearly all (96%) reported 1 or more adverse effects. About 30% of women reported discontinuing therapy, most of them (87%) because of intolerable adverse events and 47% because of joint-related problems. More than half of the respondents reported stroke, cough, swelling of arms and legs, flulike symptoms, and anxiety. Other effects included vaginal atrophy and dryness, a rise in cholesterol levels, and general pain. The full report and comments from respondents are available online.

"It's very apparent that some women who responded to the survey are really suffering," commented lead author Marilyn Zivian, PhD, in a statement. "Patients know about side effects before their doctors do — they experience them first-hand," added Barbara Brenner, executive director of BCA. Both women are breast cancer survivors.

Direct Comparison of 3 Products

A direct comparison of the 3 AIs in a phase 1 study in healthy postmenopausal women revealed differences between the drugs, particularly in the effects of these agents on lipid profiles. The Letrozole, Exemestane, and Anastrozole Pharmacodynamics (LEAP) study was reported by a team from the University of Sheffield, in the United Kingdom, in collaboration with researchers from AstraZeneca.

All 3 AIs were associated with modest increases in serum markers of bone turnover and with modest decreases in bone-mineral density (BMD) after 24 weeks of treatment, with no significant differences between agents. The researchers note that long-term administration of AIs has already been associated with a decrease in BMD and an increase in fracture risk and osteoporosis in postmenopausal breast cancer patients.

As exemestane is steroidal in nature (whereas the other 2 products are nonsteroidal), it has previously been suggested that this drug may protect against bone loss. "No evidence of such an effect was detected in this study," the researchers commented. One difference did emerge, however — only exemestane was associated with a decrease in parathyroid hormone (PTH) levels, which may indicate increased bone resorption, they suggested.

The 3 drugs showed differential effects on lipid profiles. Compared with anastrozole, treatment with letrozole and exemestane produced potentially unfavorable changes in lipid profiles of these healthy volunteers, the researchers commented. Treatment with letrozole resulted in a significant increase in triglycerides at 12 weeks, although levels were highly variable during the 36-week course of this study,...

12-22-2006, 11:40 AM	#2
Lani Senior Member Join Date: Mar 2006 Posts: 4,778	continued.... Another poster presented findings from an online patient survey carried out by the US advocacy group Breast Cancer Action (BCA). The survey, launched in August 2005, listed 38 adverse events associated with aromatase inhibitors (compiled from FDA-approved product labeling) and also asked whether respondents experienced any other unlisted adverse effects. Of 612 women who responded, nearly all (96%) reported 1 or more adverse effects. About 30% of women reported discontinuing therapy, most of them (87%) because of intolerable adverse events and 47% because of joint-related problems. More than half of the respondents reported stroke, cough, swelling of arms and legs, flulike symptoms, and anxiety. Other effects included vaginal atrophy and dryness, a rise in cholesterol levels, and general pain. The full report and comments from respondents are available online. "It's very apparent that some women who responded to the survey are really suffering," commented lead author Marilyn Zivian, PhD, in a statement. "Patients know about side effects before their doctors do — they experience them first-hand," added Barbara Brenner, executive director of BCA. Both women are breast cancer survivors. Direct Comparison of 3 Products A direct comparison of the 3 AIs in a phase 1 study in healthy postmenopausal women revealed differences between the drugs, particularly in the effects of these agents on lipid profiles. The Letrozole, Exemestane, and Anastrozole Pharmacodynamics (LEAP) study was reported by a team from the University of Sheffield, in the United Kingdom, in collaboration with researchers from AstraZeneca. All 3 AIs were associated with modest increases in serum markers of bone turnover and with modest decreases in bone-mineral density (BMD) after 24 weeks of treatment, with no significant differences between agents. The researchers note that long-term administration of AIs has already been associated with a decrease in BMD and an increase in fracture risk and osteoporosis in postmenopausal breast cancer patients. As exemestane is steroidal in nature (whereas the other 2 products are nonsteroidal), it has previously been suggested that this drug may protect against bone loss. "No evidence of such an effect was detected in this study," the researchers commented. One difference did emerge, however — only exemestane was associated with a decrease in parathyroid hormone (PTH) levels, which may indicate increased bone resorption, they suggested. The 3 drugs showed differential effects on lipid profiles. Compared with anastrozole, treatment with letrozole and exemestane produced potentially unfavorable changes in lipid profiles of these healthy volunteers, the researchers commented. Treatment with letrozole resulted in a significant increase in triglycerides at 12 weeks, although levels were highly variable during the 36-week course of this study,...