A new study by researchers at Kaiser Permanente and University of California at Los Angeles has concluded that breast cancer patients treated with aromatase inhibitors (AIs) as adjuvant endocrine therapy were at equal risk of serious cardiovascular disease (CVD) events, as compared with those treated with tamoxifen.
Researchers conducted a retrospective analysis of more than 13,000 postmenopausal women with breast cancer who were diagnosed between January 1, 1991, and December 31, 2010. The women were followed up till December 31, 2011. The diagnosis was for hormone receptor—positive breast cancer without CVD complications. The women received adjuvant endocrine therapy of tamoxifen citrate alone, AI alone, or neither, and were grouped accordingly.
During the follow-up period, a total of 3711 CVD events were recorded. Of these, AI-only users has a similar risk of cardiac ischemia (myocardial infarction and angina) (adjusted hazard ratio [HR], 0.97; 95% CI, 0.78-1.22) and stroke (adjusted HR, 0.97; 95% CI, 0.70-1.33) when compared with those treated with tamoxifen alone. However, using AI alone (adjusted HR, 1.29; 95% CI, 1.11-1.50) or subsequent to tamoxifen (adjusted HR, 1.26; 95% CI, 1.09-1.45), increased the women’s risk of other CVDs (dysrhythmia, valvular dysfunction, and pericarditis).
“Our study is a comprehensive assessment of the impact aromatase inhibitors have on cardiovascular risk and provides reassurance that the hormone therapy to reduce breast cancer recurrence does not increase risk of the most fatal cardiovascular events,” said Reina Haque, PhD, MPH, research scientist, Kaiser Permanente Southern California Department of Research & Evaluation, in a statement. Haque is the lead author on the study, which has been published in JAMA Oncology. “A particular strength of our study is that we accounted for women’s other potential cardiovascular risk factors as well as medication used to treat high blood pressure and high cholesterol.”
Based on their findings, the authors believe that further studies to assess the risk of other CVD events are warranted.
Reference
Haque R, Shi J, Schottinger JE, et al. Cardiovascular disease after aromatase inhibitor use [published online April 21, 2016]. JAMA Oncol. doi:10.1001/jamaoncol.2016.0429.
Examining Low-Value Cancer Care Trends Amidst the COVID-19 Pandemic
April 25th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the April 2024 issue of The American Journal of Managed Care® about their findings on the rates of low-value cancer care services throughout the COVID-19 pandemic.
Listen
Lack of Mutations Associated With Favorable Prognosis in MPN-U
April 25th 2024While the Dynamic International Prognostic Scoring System and bone marrow blasts may predict overall survival, the lack of certain mutations is also associated with a better prognosis for myeloproliferative neoplasm, unclassifiable (MPN-U).
Read More
What We’re Reading: FDA Approves UTI Antibiotic; Ozempic, Wegovy Price Investigation; US Births Fall
April 25th 2024The FDA recently approved an antibiotic for the treatment of urinary tract infections (UTIs) in women; a Senate committee recently launched an investigation into the prices of Novo Nordisk’s diabetes and weight loss drugs; US births fell last year, resuming a national slide after a previous increase during the pandemic.
Read More