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Aromatase inhibitors associated with increased CV risk in postmenopausal women
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33rd Annual San Antonio Breast Cancer Symposium
SAN ANTONIO — Data from a meta-analysis presented here demonstrate that postmenopausal women taking aromatase inhibitors for the treatment of breast cancer may be at an increased risk for cardiotoxic side effects, including heart attack, angina and heart failure.
Researchers examined data from seven randomized trials to determine the differences in serious adverse events associated with aromatase inhibitors vs. tamoxifen in postmenopausal women treated for early-stage breast cancer.
According to the analysis, treatment with aromatase inhibitors for any time period was associated with a higher risk for developing cardiovascular disease (OR=1.20; P=.01) and bone fractures (OR=1.48; P<.00001). However, treatment with AIs was associated with a reduced risk for venous thrombosis (OR=0.53; P<.00001) and endometrial cancer (OR=0.32; P<.00001). Upfront treatment with AIs and treatment with an AI after tamoxifen were associated with similar risks for individual serious adverse events.
The researchers observed a non-significant trend toward increased death without recurrence with upfront treatment with AIs (OR=1.12; P=.16), but the trend was lower when treatment was switched to AIs after tamoxifen (OR=0.74; P=.03).
“Treatment with AIs is associated with a statistically significant increase in cardiovascular risk, which is of similar magnitude to the risk of venous thrombosis and endometrial cancer with 5 years of tamoxifen,” the researchers wrote. “While switching to AIs does not appear to reduce the risk for the development of serious AEs when compared to upfront use of AIs, fewer deaths unrelated to breast cancer occur with switching than with upfront strategies.”
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