Rheumatoid Arthritis and AIs

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TallnTerrific
TallnTerrific Member Posts: 114
edited April 2018 in Hormonal Therapy - Before, During, and After
Has anyone found that the reduction of hormones from years of taking AIs has resulted in the development of Rheumatoid Arthritis?
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  • KleeKai
    KleeKai Member Posts: 29
    edited December 2017

    Hi,

    I've been experiencing various joint pain since cycle 3 of chemotherapy.  I'm more than 2+ years out from completing my cancer treatment but the joint pain has increased.  I have been told I have early stage osteoarthritis in both hands, bursitis in both my right hip and shoulder, plantar fasciitis in both feet, and tendonitis in both knees, both ankles and right elbow.  I have seen a rheumatologist but not much has been done to explain why so much joint inflammation so my oncologist wants me to see a different rheumatologist.  My onc ran the CRP and sed rate - both were high.  The RF and ANA were negative but that doesn't rule out rheumatoid, these are just another piece of the puzzle. I just want an answer to why so much inflammation, which is what I hope the new rheumatologist can help with.

    I was on Arimidex for 3-months but my onc switched me to Letrozole when my joint pain worsened in August.  I was off Letrozole for three weeks in December and did 30-days of PT during that time for my hip and ankles with no relief from the joint pain.  My onc and I agree it's not the aromatase inhibitor that's causing the joint pain. 

    Have you been diagnosed with RA?

    Thanks,

    Louise

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  • TallnTerrific
    TallnTerrific Member Posts: 114
    edited January 2018

    KleeKai,I have not been diagnosed with RA yet. I had an ANA test that came back normal. However, I have many of the same symptoms as you do. I have been on all of the AIs and had increasing trouble with muscle and joint pain primarily in my back, hips and legs. I was off all AIs in December and the pain continued to get worse. Starting in November 2017 both hands began to hurt badly at night and then I would wake up with pain stiffness and the beginning symptoms of a trigger finger. Now I experience sharp pain in my back and thigh at night if I try to move or turn over and I wake up feeling like an old woman - bent and very achy. I am only 58, so I did not expect such sudden changes. I am learning that my pain sounds more like RA than anything else. So I began to investigate whether that was common among woman with breast cancer. Since RA is also autoimmune I was curious if others had this combination. Perhaps the AIs actually contribute to it by eliminating all estrogen needed to keep everything working properly.


    If that is the case perhaps we should be consulted before we are put on AIs whether we wanted to live a longer life suffering from RA or take our chances with the cancer. I am not sure what I would choose.

    Thanks for your note, Louise


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  • KleeKai
    KleeKai Member Posts: 29
    edited January 2018

    I have an appointment to see the new rheumy at last - but it's Feb 26.  Have you found anything to ease your pain?  I've tried Advil, Aleve, even Tylenol Arthritis and found no relief.  It's a bit better when I use Salonpas but the directions say not to use it more then 3-days in a row.  Icy Hot and Biofreeze are good but the effects don't last long.  

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  • Susaine
    Susaine Member Posts: 28
    edited January 2018

    Rheumatoid Arthritis is causing severe pains in my legs.

    First my doctor insisted me that it is serum uric acid projections later he confirmed that it as Rheumatoid Arthritis.

    Can I anyone advise me suitable diet to lower Rheumatoid Arthritis?

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  • marijen
    marijen Member Posts: 3,731
    edited February 2018

    Link between bacteria in milk and rheumatoid arthitis

    https://www.news-medical.net/news/20180130/Researc...


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  • KleeKai
    KleeKai Member Posts: 29
    edited March 2018

    Hi - the new rheumatologist confirmed osteoarthritis in my hands, knees and ankles.  There is a hereditary factor involved but it comes down to chemo depleting all the estrogen.  The arthritis came on early.  All my labs came back normal, and xrays of my hands showed some arthritis changes.  

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  • Jo62
    Jo62 Member Posts: 3
    edited April 2018

    New to forum, hello all. I am just finishing my therapy-3 months of chemo and 30 days of radiation. My MO has now prescribed Arimidex. Taking the listed items below into consideration

    I am weighing my decision to go with AI's.

    ---I have been successfully managing rheumatoid arthritis for 15 years with medication

    ---I was diagnosed with depression 30 years ago and since have been taking medication successfully

    ---I recently (a month before starting chemo) had angioplasty and dx with cardiac disease

    ---I have osteopenia

    ---I am post menopausal and don't have ovaries or a uterus

    I have been reading alot of research, along with personal experience on this board and others and it seems that AI's might be an antagonist

    for all of the above. I am very fearful that any AI or Tamoxifen would affect quality of life. I am visiting with Rheumatologist and MO this week

    and would like to know if anyone else has had a similar experience? I am leaning toward refusing all hormone therapy.


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  • marijen
    marijen Member Posts: 3,731
    edited April 2018

    I don’t know if this will help. Funny I just came across this RA and AI article this am, there are more at PubMed.

    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.

    Caprioli M1, Carrara G2, Sakellariou G3, Silvagni E4, Scirè CA2,4.

    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

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

    Free PMC Article

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