title: Prevalence of aromatase inhibitor-induced arthralgia in breast cancer: a systematic review and meta-analysis.
abstract: Although aromatase inhibitors have proven to be an effective treatment of hormone receptor-positive breast cancer in postmenopausal women, aromatase inhibitor-induced arthralgia (AIA) is an adverse event associated with low compliance with treatment. The aim of this literature study is to assess the prevalence of AIA and to provide an overview of significant predictors for the development of AIA.
  
  
  
  A systematic review was conducted using PubMed, Cochrane Library and Web of Science. A meta-analysis was performed and heterogeneity has been investigated by moderator analyses. The meta-analysis was repeated with studies that were considered as best evidence, i.e. studies with an above-average score on the STROBE checklist.
  
  
  
  Twenty-one studies (13,177 participants) were included. Prevalence rates ranged from 0.200 to 0.737. Meta-analysis resulted in a pooled estimate of 0.459 (95% CI = [0.397-0.520) with a high heterogeneity (I2= 98%). Moderator analysis showed no differences regarding heterogeneity. Predictors for the development of AIA included a body mass index of 25-30 kg/m2(OR = 0.33), taxane-based chemotherapy (OR = 4.08), stage III cancer (OR = 0.32) and a duration of menopause of 5-10 years (OR = 1.10) or >10 years (OR = 0.44-3.29) (An OR <1 indicates a predictor of lower risk of AIA).
  
  
  
  Despite the established benefits of AI, an important portion of the patients experiences AIA. More research is needed to investigate the efficacy of treatments such as exercise therapy for AIA.
authors.affiliation: Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium. david.beckwee@vub.ac.be.|Frailty in Ageing Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium. david.beckwee@vub.ac.be.
authors.forename: David
authors.identifier: 0000-0001-9951-9993
authors.initials: D
authors.lastname: Beckwée
authors.affiliation: Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.|Pain in Motion Research Group, Brussels, Belgium.
authors.forename: Laurence
authors.initials: L
authors.lastname: Leysen
authors.affiliation: Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
authors.forename: Kaipo
authors.initials: K
authors.lastname: Meuwis
authors.affiliation: Rehabilitation Sciences Research Department, Vrije Universiteit Brussel, Laarbeeklaan 103, 1090, Brussels, Belgium.
authors.forename: Nele
authors.initials: N
authors.lastname: Adriaenssens
mesh_terms: D047072:Aromatase Inhibitors / Q000009:adverse effects*; D018771:Arthralgia / Q000139:chemically induced*; D001943:Breast Neoplasms / Q000188:drug therapy* / Q000473:pathology; D005260:Female; D006801:Humans; D015995:Prevalence; D016896:Treatment Outcome
chemical_list: D047072:Aromatase Inhibitors
keywords: Aromatase inhibitor; Arthralgia; Breast cancer; Prevalence