Vitamin D role in preventing aromatase inhibitor-induced arthralgia

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Vitamin D threshold to prevent aromatase inhibitor-induced arthralgia: a prospective cohort study

Breast Cancer Research and Treatment, 08/04/2010
Exclusive author commentary
Prieto–Alhambra D et al.

Aromatase inhibitor (AI)–associated arthralgia limits adherence to therapy in breast cancer...After supplementation (daily 800 IU and additional 16,000 IU every 2 weeks), 50% of them still failed to reach adequate concentrations at 3 months. In the whole cohort, there was an increase in joint pain and the increase was significantly attenuated in those that reached concentrations of 25(OH)D of > or =40 ng/ml, with a lower risk of incident arthralgia. A target concentration of 40 ng/ml 25OHD may prevent development of AI arthralgia but higher loading doses are required to attain this level in women with deficiency at baseline.

Daniel Prieto-Alhambra (08/05/2010) comments:
Adherence to aromatase inhibitor(AI) therapy is required to improve survival in women with early breast cancer who can be treated with these drugs. AI-induced arthralgia is highly associated with discontinuation. We have shown for the first time that Vitamin D repletion (with target concentrations > or 40ng/ml) might prevent development of joint pain associated with AI therapy, and thus, may improve adherence. A randomized clinical trial is required now to ensure causality."