Aromatase Inhibitors AIs: Definition, Uses, Side Effects, and More

A 2018 study in the Journal of Clinical Oncology also noted that the risk of diabetes was 240% greater in women on aromatase inhibitors than in the general population. Although the risk was far lower with tamoxifen, aromatase inhibitors do not pose the risk of thromboembolism (blood clots) or endometrial cancer that tamoxifen does. The cost in the gap of the three aromatase inhibitors increased from 32% to 56% between 2007 and 2010, but these costs fell between 9 and 85% between 2007 and 2011. In contrast the cost in the gap of tamoxifen, already less than one-tenth of the aromatase inhibitor cost in 2007, fell by 27% in 2010 and by 38% in 2011. Costs for all medications were much more moderate in the catastrophic phase.

Description of Included Studies

The submodel is a separate partitioned survival model with 2health states (progression-free survival and post-progression survival) and death, representing health outcomes and costs incurred on second-line and subsequent treatments applied post progression. Calibration is used to adjust the time spent in the submodel to reflect the assumed relationship between progression-free survival and overall https://macau123slot.co/steroid-courses-for-drying-and-body-shaping-lean/ survival. The ERG noted that this is a new approach that explicitly models second-line treatments to reduce uncertainty around overall survival. This approach has similarities, but is not identical, to that used in NICE’s technology appraisal guidance on ribociclib.

Your doctor might recommend you take tamoxifen to lower the risk of breast cancer coming back (recurring) after surgery. You may also have tamoxifen before surgery or if you have secondary breast cancer. You might have hormone therapy when secondary breast cancer is first diagnosed.

Scenario Analyses

However, some premenopausal women may take an aromatase inhibitor when combined with ovarian suppression, which shuts down the ovaries. Women who take an aromatase inhibitor for more than 5 years continue to have side effects while taking the drug, including a higher number of bone fractures and a higher rate of osteoporosis 122, . However, overall survival is the same whether a woman takes an aromatase inhibitor for 5 years or 10 years . For most women, the benefit of the extra 5 years of treatment is small 122.

• The aromatase inhibitors anastrozole and letrozole are approved to be given to postmenopausal women as initial therapy for metastatic or locally advanced hormone-sensitive breast cancer (12, 13).
• The treatment of AIMSS and the identification of clinical predictors of AIMSS onset is a rapidly evolving field of inquiry, and our results are current only up to January 8, 2025.
• Such an approach would leverage existing knowledge on the natural history of disease and consider uncertainty to better inform adoption of new cancer therapies.
• They will weigh up the benefit of taking the drug for longer with other factors, such as any side effects you have and whether you want to have children.

If you can’t have tamoxifen for any reason, your doctor might recommend you have other types of hormone therapy such as an aromatase inhibitor. One of the most common types of hormone therapy used for breast cancer is tamoxifen. Aromatase inhibitors are medicines that reduce the amount of estrogen in the body.

One of the interactions that can be seen in this population is the concurrent use of methadone for chronic pain control. CYP19, an aromatase enzyme, theoretically plays a role in the metabolism of methadone. The inhibition of this enzyme by AI therapy leads to increased levels of methadone in the body, increasing the risk of potential serious side effects such as respiratory depression and QTc prolongation (Lu, Thong, & Flockhart, 2012; see Appendix A).