Randomized exercise trial of aromatase inhibitor-induced arthralgia in breast cancer survivors
Open accessAbstract
Purpose: Arthralgia occurs in up to 50% of breast cancer survivors treated with aromatase inhibitors (AIs) and is the most common reason for poor AI adherence. We conducted, in 121 breast cancer survivors receiving an AI and reporting arthralgia, a yearlong randomized trial of the impact of exercise versus usual care on arthralgia severity. Patients and Methods: Eligibility criteria included receiving an AI for at least 6 months, reporting ≥ 3 of 10 for worst joint pain on the Brief Pain Inventory (BPI), and reporting < 90 minutes per week of aerobic exercise and no strength training. Participants were randomly assigned to exercise (150 minutes per week of aerobic exercise and supervised strength training twice per week) or usual care. The BPI, Western Ontario and McMaster Universities Osteoarthritis (WOMAC) index, and Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire were completed at baseline and at 3, 6, 9, and 12 months. Intervention effects were evaluated using mixed-model repeated measures analysis, with change at 12 months as the primary end point. Results: Over 12 months, women randomly assigned to exercise (n = 61) attended 70% (± standard deviation [SD], 28%) of resistance training sessions and increased their exercise by 159 (± SD, 136) minutes per week. Worst joint pain scores decreased by 1.6 points (29%) at 12 months among women randomly assigned to exercise versus a 0.2-point increase (3%) among those receiving usual care (n = 60; P < .001). Pain severity and interference, as well as DASH and WOMAC pain scores, also decreased significantly at 12 months in women randomly assigned to exercise, compared with increases for those receiving usual care (all P < .001). Conclusion: Exercise led to improvement in AI-induced arthralgia in previously inactive breast cancer survivors.
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Promising results from animal studies are emerging for a protective effect of aerobic training on cancer treatment-related changes in cognitive function, but evidence in humans is limited.
“While promising results from animal studies are emerging for a protective effect of aerobic training on cancer treatment related changes in cognitive function, to date, the evidence in humans is limited(58).”
From Exercise Guidelines for Cancer Survivors: Consensus Statement from International Multidisciplinary Roundtable (2019) · cites this paper as [58]
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Self-citation
- Authors
- Irwin, M. L., Cartmel, B., Gross, C. P., Ercolano, E., Li, F., Yao, X., Fiellin, M., Capozza, S., Rothbard, M., Zhou, Y., Harrigan, M., Sanft, T., Schmitz, K., Neogi, T., Hershman, D., & Ligibel, J.
- Affiliations
- Boston University (US)
- Corresponding author
- Irwin, Melinda L.
- ORCID
- Venue
- Journal of Clinical Oncology
- Published
- 2015-04-01
- Volume
- 33
- Issue
- 10
- Pages
- 1104-1111
- ISSN
- 0732-183X (ISSN-L)
- 1527-7755
- PMC
- PMC4372849
- OpenAlex
- W2152427545
- Cited by
- 324
- References
- 34
- Citations by year
- 2026: 17 · 2025: 17 · 2024: 26 · 2023: 26 · 2022: 25 · 2021: 34 · 2020: 31 · 2019: 28 · 2018: 38 · 2017: 39 · 2016: 28 · 2015: 14 · 2013: 1
- FWCI
- 13.04
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- Journal of Clinical Oncology (publishedVersion)
- PubMed Central (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Breast Cancer Research Foundation (P30 CA016359)
- State of Connecticut Department of Public Health
- Yale University (UL1 TR000142)
- Yale Cancer Center (P30-CA016359, Support Grant No. P30 CA016359, UL1 TR000142)
- National Institutes of Health (UL1TR000142, CA016359, TR000142)
- National Cancer Institute (R01CA132931, Grant No. R01 CA132931, CA-016359, P30CA016359)
- National Institute of Arthritis and Musculoskeletal and Skin Diseases (P60AR047785)
- National Center for Advancing Translational Sciences
- Topics
- Health Sciences › Medicine › Oncology › Cancer survivorship and care
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Cancer-related cognitive impairment studies
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Cancer Research › Breast Cancer Treatment Studies
- Keywords
- aromatase inhibitor-induced arthralgia, breast cancer survivors, exercise intervention, aerobic exercise, resistance training, joint pain, pain intensity, exercise adherence, WOMAC, DASH, Brief Pain Inventory, osteoarthritis
- MeSH terms
- Aged, Breast Neoplasms, Disability Evaluation, Exercise Therapy, Female, Humans, Middle Aged, Pain Measurement, Surveys and Questionnaires, Time Factors, Treatment Outcome, Survivors, Arthralgia, Aromatase Inhibitors
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