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Therapeutic options for aromatase inhibitor-associated arthralgia in breast cancer survivors: A systematic review of systematic reviews, evidence mapping, and network meta-analysis.

Maturitas
December 1, 2018
Tae-Hun Kim et al. (3 authors)
Journal ArticleSystematic ReviewNetwork Meta-AnalysisHuman Study
Study Details

Study Goal

The researchers aimed to assess the effectiveness of Nordic walking as a therapeutic option for aromatase inhibitor-associated arthralgia (AIA) in breast cancer survivors.

Results Summary

Nordic walking was one of the less frequently assessed interventions, but the study found that aerobic exercise (which includes walking) significantly improved pain severity scores compared to a waiting list control. The evidence for Nordic walking specifically was not detailed, but aerobic exercise showed modest efficacy.

Population

Breast cancer survivors experiencing aromatase inhibitor-associated arthralgia (AIA).

Effective Dosage

Not specified

Duration

Not specified

Interactions

None mentioned

Extracted Claims (3)
InterventionDirectionEndpointPopulationDosageImpactClaim #
Acupuncture
decrease
pain severity scores
-
mean difference [MD] -2.00, 95% confidence interval [CI] -3.16, -0.84
significantly improved
#1
Aerobic exercise
decrease
pain severity scores
-
mean difference [MD] -0.80, 95% confidence interval [CI] -1.33, -0.016
significantly improved
#2
Omega-3 fatty acids
decrease
pain severity scores
-
mean difference [MD] -2.10, 95% confidence interval [CI] -3.23, -0.97
significantly improved
#3
Abstract

Aromatase inhibitor-associated arthralgia (AIA) is a common problem in breast cancer survivors and is associated with noncompliance with aromatase inhibitor therapy. The aim of this research was to assess the current evidence for the various therapeutic options available for AIA. We searched the PubMed, EMBASE, Cochrane Database of Systematic Reviews, and Database of Abstracts of Reviews of Effects for systematic reviews of trials investigating treatments for AIA to June 2018. Eligible systematic reviews were subjected to evidence mapping and the randomized controlled trials included in the systematic reviews were hand-searched for a network meta-analysis. Six systematic reviews were included in the evidence mapping. Acupuncture was the most common treatment modality studied (four randomized controlled trials), and pharmacological interventions, aerobic exercise, Nordic walking, omega-3 fatty acids, and vitamin D were assessed less frequently. In view of the limitations in the overall confidence level for each review, the evidence for acupuncture as an effective treatment for AIA was considered low. Second, data from 6 randomized controlled trials were included in the network meta-analysis. When compared with a waiting list control, acupuncture (mean difference [MD] -2.00, 95% confidence interval [CI] -3.16, -0.84), aerobic exercise (MD -0.80, 95% CI -1.33, -0.016), and omega-3 fatty acids (MD -2.10, 95% CI -3.23, -0.97) significantly improved pain severity scores. Network meta-analysis of adverse events was not possible because of poor reporting. Acupuncture is presently the most widely investigated intervention but is recommended for AIA with low overall confidence based on the current evidence.

Medical Subject Headings (MeSH)
Acupuncture TherapyAromatase InhibitorsArthralgiaBreast NeoplasmsCancer SurvivorsEvidence-Based MedicineExerciseFatty Acids, Omega-3FemaleHumansPain MeasurementReview Literature as TopicVitamin D
Study Links
Quality Scores
SafetyNot Assessed
Efficacy65/10
Quality75/10
Citation Metrics
Total Citations22
Citations/Year3.1
Relative Citation Ratio1.27
NIH Percentile59.2%
Research Impact Scores
APT Score0.75
Weight Score2.06
Normalized Score0.61
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