Display options
Cite
Caprioli M, Carrara G, Sakellariou G, et al. Influence of aromatase inhibitors therapy on the occurrence of rheumatoid arthritis in women with breast cancer: results from a large population-based study of the Italian Society for Rheumatology. RMD Open. 2017;3(2):e000523doi: 10.1136/rmdopen-2017-000523.
Caprioli, M., Carrara, G., Sakellariou, G., Silvagni, E., & Scirè, C. A. (2017). Influence of aromatase inhibitors therapy on the occurrence of rheumatoid arthritis in women with breast cancer: results from a large population-based study of the Italian Society for Rheumatology. RMD open, 3(2), e000523. https://doi.org/10.1136/rmdopen-2017-000523
Caprioli, Marta, et al. "Influence of aromatase inhibitors therapy on the occurrence of rheumatoid arthritis in women with breast cancer: results from a large population-based study of the Italian Society for Rheumatology." RMD open vol. 3,2 (2017): e000523. doi: https://doi.org/10.1136/rmdopen-2017-000523
Caprioli M, Carrara G, Sakellariou G, Silvagni E, Scirè CA. Influence of aromatase inhibitors therapy on the occurrence of rheumatoid arthritis in women with breast cancer: results from a large population-based study of the Italian Society for Rheumatology. RMD Open. 2017 Sep 28;3(2):e000523. doi: 10.1136/rmdopen-2017-000523. eCollection 2017. PMID: 29071118; PMCID: PMC5640089.
Copy Download .nbib Format: NLM
Share it on

RMD Open. 2017 Sep 28;3(2):e000523. doi: 10.1136/rmdopen-2017-000523. eCollection 2017.

Influence of aromatase inhibitors therapy on the occurrence of rheumatoid arthritis in women with breast cancer: results from a large population-based study of the Italian Society for Rheumatology.

RMD open

Marta Caprioli, Greta Carrara, Garifallia Sakellariou, Ettore Silvagni, Carlo Alberto Scirè

Affiliations

  1. Division of Rheumatology and Clinical Immunology, Humanitas Clinical and Research Center, Rozzano, Italy.
  2. Epidemiology Unit, Italian Society for Rheumatology (SIR), Milan, Italy.
  3. Chair and Division of Rheumatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy.
  4. Rheumatology Unit, Department of Medical Sciences, University of Ferrara, Ferrara, Italy.

PMID: 29071118 PMCID: PMC5640089 DOI: 10.1136/rmdopen-2017-000523

Abstract

OBJECTIVES: The purpose of this study was to evaluate the risk of developing rheumatoid arthritis (RA) in a population of patients with breast cancer treated with aromatase inhibitors (AIs) compared with tamoxifen.

METHODS: Data were collected from the administrative healthcare database of Lombardy Region, Italy, from 2004 to 2013. This study follows a nested cohort design, including women with a diagnosis of breast cancer starting treatment with tamoxifen, anastrozole, exemestane or letrozole. The risk of RA related to the prescription of the different drugs was estimated by survival models for competing risks and the results are presented as hazard ratios (HRs) and 95% confidence intervals (95% CI), adjusted for age and cancer severity.

RESULTS: Out of total 10 493 women with breast cancer with a median (IQR) age of 66 (57-74), 7533 (71.8%) started an active treatment with AIs or tamoxifen. In this subgroup a total of 113 new cases of RA developed during the 26 105.9 person-year of 10 186 exposure periods, including time varying exposures in the same patient. Using tamoxifen as reference category, AIs therapy was associated with an increased risk of RA (adjusted HR 1.62 (95%1.03-2.56)), in particular in patients receiving anastrozole, even after adjusting for age and level of neoplasia: (adjusted HR 1.75 (95%1.07-2.86)).

CONCLUSIONS: In a large population-based sample of women with breast cancer, exposure to AIs compared with tamoxifen is associated with a significantly increased risk of RA, which is not influenced by the cancer severity and the relationship of age with indication to specific drugs.

Keywords: aromatase inhibitors; breast cancer; rheumatoid arthritis; tamoxifene

Conflict of interest statement

Competing interests: None declared.

References

  1. Joint Bone Spine. 2011 Jan;78(1):62-4 - PubMed
  2. BMJ Open. 2015 Jan 28;5(1):e006029 - PubMed
  3. J Rheumatol. 2015 Jan;42(1):55-9 - PubMed
  4. Breast Cancer Res Treat. 2012 Jan;131(2):699-708 - PubMed
  5. Exp Gerontol. 2009 Jun-Jul;44(6-7):398-405 - PubMed
  6. Br J Rheumatol. 1994 Jun;33(6):583-5 - PubMed
  7. J Rheumatol. 2007 Nov;34(11):2259-63 - PubMed
  8. Ann N Y Acad Sci. 2014 May;1317:24-31 - PubMed
  9. Ann Oncol. 2013 Jun;24(6):1443-9 - PubMed
  10. J Rheumatol. 2009 May;36(5):1087-8 - PubMed
  11. Lancet. 2005 Jan 1-7;365(9453):60-2 - PubMed
  12. Breast Cancer Res Treat. 2010 Apr;120(3):525-38 - PubMed
  13. Joint Bone Spine. 2014 Mar;81(2):187-8 - PubMed
  14. Arthritis Care Res (Hoboken). 2012 Dec;64(12):1910-8 - PubMed
  15. Ann Rheum Dis. 2007 Apr;66(4):557-8 - PubMed
  16. Rheumatology (Oxford). 2017 Aug 1;56(8):1254-1263 - PubMed
  17. Br J Rheumatol. 1994 Oct;33(10):998 - PubMed
  18. Clin Exp Rheumatol. 2013 Jul-Aug;31(4):653-4 - PubMed

Publication Types