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Title: Prospective study to assess fluid accumulation and tenosynovial changes in the aromatase inhibitor-induced musculoskeletal syndrome: 2-year follow-up data
Authors: Lintermans, Anneleen ×
Laenen, Annouschka
Van Calster, Ben
Van Hoydonck, M
Pans, S
Verhaeghe, J
Westhovens, Rene
Henry, N L
Wildiers, Hans
Paridaens, Robert
Dieudonné, Anne-Sophie
Leunen, Karin
Morales, L
Verschueren, K
Timmerman, Dirk
De Smet, L
Vergote, Ignace
Christiaens, Rose
Neven, Patrick #
Issue Date: Feb-2013
Publisher: Kluwer Academic Publishers
Series Title: Annals of Oncology vol:24 issue:2 pages:350-5
Abstract: BackgroundAromatase inhibitors (AIs) frequently lead to the AI-induced musculoskeletal syndrome (AIMSS). Looking into its pathophysiology, 6 months of AI therapy thickens the tendon sheath with intra-articular fluid (IAF) retention and loss of grip strength. We here report 24-month follow-up data.Patients and methodsA prospective cohort study of 33 postmenopausal breast cancer patients received adjuvant endocrine therapy; 27 received an AI and 6 received tamoxifen. At baseline, 6 and 24 months patients had a rheumatologic examination, including a grip strength test, and magnetic resonance imaging of both hands and wrists. The primary end point was tenosynovial changes; secondary end points were changes in morning stiffness, grip strength and IAF.ResultsTwenty-three AI and 5 tamoxifen patients completed all investigations. Between month 6 and 24, IAF further increased in AI users (P = 0.04) but not in tamoxifen users, and grip strength further decreased in both groups. The worsened tenosynovial changes were strongly correlated with a decrease in grip strength. At 24 months, morning stiffness continued to be present in over a third of AI users.ConclusionAIMSS represents a substantial problem in breast cancer patients. It is associated with tenosynovial changes, IAF retention, joint stiffness and loss of grip strength that do not improve with prolonged use.
URI: 
ISSN: 0923-7534
Publication status: published
KU Leuven publication type: IT
Appears in Collections:Laboratory of Experimental Oncology
Gynaecological Oncology
Surgical Oncology
Leuven Biostatistics and Statistical Bioinformatics Centre (L-BioStat)
× corresponding author
# (joint) last author

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