PURPOSE:Many women with hormone receptor-positive breast cancer discontinue effective aromatase inhibitor (AI) treatment due to joint symptoms. METHODS:We conducted a single-arm, open-label, phase II study evaluating glucosamine-sulfate (1,500 mg/day) + chondroitin-sulfate (1,200 mg/day) for 24 weeks to treat joint pain/stiffness in postmenopausal women with early stage breast cancer who developed moderate-to-severe joint pain after initiating AIs. The primary endpoint was improvement in pain/stiffness at week 24 assessed by the Outcome Measure in Rheumatology Clinical Trials and Osteoarthritis Research Society International (OMERACT-OARSI) criteria. Secondary endpoints assessed changes in pain, stiffness, and function using the Western Ontario and McMaster Universities Osteoarthritis (WOMAC) Index for hips/knees and the Modified Score for the Assessment and Quantification of Chronic Rheumatoid Affections of the Hands (M-SACRAH) for hands/wrists. The Brief Pain Inventory (BPI) assessed pain interference, severity, and worst pain. RESULTS:Of 53 patients enrolled, 39 were evaluable at week 24. From baseline to week 24, 46 % of patients improved according to OMERACT-OARSI criteria. At week 24, there were improvements (all P < 0.05) in pain and function as assessed by WOMAC and M-SACRAH, and in pain interference, severity, and worst pain as assessed by BPI. Estradiol levels did not change from baseline. The most commonly reported side effects were headache (28 %), dyspepsia (15 %), and nausea (17 %). CONCLUSIONS:In this single-arm study, 24 weeks of glucosamine/chondroitin resulted in moderate improvements in AI-induced arthralgias, with minimal side effects, and no changes in estradiol levels. These results suggest a need to evaluate efficacy in a placebo-controlled trial.

译文

目的:许多患有激素受体阳性乳腺癌的妇女由于关节症状而停止有效的芳香化酶抑制剂(AI)治疗。
方法:我们进行了单臂,开放标签,II期研究,评估硫酸氨基葡萄糖(1,500毫克/天)硫酸软骨素(1200毫克/天)持续24周,以治疗绝经后早期女性的关节痛/僵硬启动AI后出现中度至重度关节痛的乳腺癌患者。主要终点是通过风湿病临床试验和国际骨关节炎研究协会(OMERACT-OARSI)标准中的结果评估标准评估的第24周疼痛/僵硬的改善。次要终点是使用西安大略省和麦克马斯特大学骨关节炎(WOMAC)指数评估臀部/膝盖的疼痛,僵硬和功能的变化,以及评估手的慢性类风湿病影响和量化的改良分数(M-SACRAH) / wrists。简短疼痛清单(BPI)评估了疼痛的干扰,严重程度和最严重的疼痛。
结果:在入组的53例患者中,有39例在第24周得到了评估。从基线到第24周,根据OMERACT-OARSI标准,有46%的患者得到了改善。在第24周时,WOMAC和M-SACRAH评估的疼痛和功能以及BPI评估的疼痛干扰,严重程度和最严重疼痛得到改善(所有P <0.05)。雌二醇水平与基线相比没有变化。最常见的副作用是头痛(28%),消化不良(15%)和恶心(17%)。
结论:在这项单臂研究中,葡萄糖胺/软骨素的24周可导致AI引起的关节痛适度改善,副作用最小,且雌二醇水平无变化。这些结果表明需要在安慰剂对照试验中评估疗效。

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