Physical activity to reduce joint pain during aromatase inhibitor therapy

芳香酶抑制剂治疗期间进行体力活动可减轻关节疼痛

• 批准号: 8700351
• 负责人: LEIGH Fleming CALLAHAN
• 金额: $ 19.54万
• 依托单位: UNIV OF NORTH CAROLINA CHAPEL HILL
• 依托单位国家: 美国
• 财政年份: 2013
• 资助国家: 美国
• 起止时间: 2013-07-12 至 2016-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/8700351
• 关键词: Address; Adherence; Adjuvant; Adult; Adverse effects; Adverse event; Am 80; Aromatase Inhibitors; Arthralgia; Arthritis; Benign; Cancer Patient; Cancer Survivor; Cardiovascular system; Clinic; Clinic Visits; Communication; Data; Development; Diagnosis; Disease-Free Survival; Dose; Effectiveness; Endocrine; Epidemiologic Studies; Etiology; Evaluation; Fatigue; Female Breast Carcinoma; Foundations; Future; General Population; General Practices; Health Promotion; High Prevalence; Hormone Receptor; Hormones; Internal Medicine; Intervention; Intervention Trial; Interview; Joints; Life; Malignant Neoplasms; Manuscripts; Mediator of activation protein; Musculoskeletal; National Cancer Institute; Non-Steroidal Anti-Inflammatory Agents; Nurse Practitioners; Nurses; Oncologist; Outcome; Pain-Free; Participant; Patients; Physical activity; Physicians; Postmenopause; Production; Qualitative Research; Quality of life; Randomized Controlled Trials; Recruitment Activity; Recurrence; Reporting; Research; Safety; Sampling; Self Efficacy; Self Medication; Severities; Site; Staging; Summary Reports; Survivors; Symptoms; Target Populations; Testing; Time; Visit; Waiting Lists; Walking; Woman; abstracting; base; clinical practice; design; evidence base; experience; flyer; follow-up; improved; interest; lifetime risk; malignant breast neoplasm; new technology; older women; oncology; patient population; primary outcome; programs; public health relevance; satisfaction; secondary outcome; symptom management; tumor

DESCRIPTION (provided by applicant): Breast cancer is the second most common cancer among women in the U.S., with an estimated 207,090 new diagnoses in 2010 and a lifetime risk among women born today of 1 in 8. Most breast cancer cases are diagnosed among postmenopausal women at an early and treatable stage, and most of their tumors (70-80%) are hormone-receptor positive. For these women, standard adjuvant endocrine treatment is aromatase inhibitor (AI) therapy to prolong disease-free survival and time-to-recurrence. Unfortunately, joint pain/stiffness/ achiness is a common side-effect of AIs, with estimates of joint complaints ranging from 46% to 74% among survivors seen in clinical practice. The precise etiology of AI-associated musculoskeletal symptoms (AIMSS) remains unclear and is complicated by the high prevalence of benign and non-specific musculoskeletal symptoms in the general population of older women, such as arthritis. AI discontinuation due to side-effect severity is an estimated 20-32%, and is of great concern among oncologists. Research is needed to identify effective, easy-to-use, sustainable, and safe alternative or adjunct approaches to AIMSS management, so that breast cancer survivors are able to remain on AI therapy and have a life that is as pain-free as possible. We propose to investigate whether moderate-intensive physical activity (PA) can provide relief from AIMSS within a sample of female breast cancer survivors on AI therapy who report moderate to severe joint symptoms. Specifically, we propose to adapt and test the Arthritis Foundation's Walk With Ease (WWE) program, which is evidence-based for reducing joint pain, stiffness and fatigue among adults with arthritis and is available in a self-directed (non-group) format. Our "proof of concept" hypotheses are that: (a) it is feasible to adapt WWE for our target patient population and (b) that an adapted WWE can provide joint pain/symptom relief for patients with AIMSS similar to that of adults with arthritis. To investigate these hypotheses, we propose to: (1) develop an initial adaptation of WWE-Breast Cancer (WWE-BC) based on interviews with breast cancer survivors (N=20) focused on barriers and facilitators to engaging in PA; (2) conduct a preliminary assessment of the effect of WWE-BC within a new sample of survivors (N=60) with regard to (a) engaging in PA, (b) managing joint pain/symptoms and (c) remaining on AI therapy; and (3) develop WWE-BC messages and communication strategies based on interviews with survivors and oncology physicians, nurse practitioners and nurse navigators. Data on the acceptability, feasibility, safety and promise of WWE-BC gathered through this study will inform the development of a larger study to test the effectiveness of WWE-BC, identify potential effect mediators and/or moderators, and establish generalizability. All aspects of our study will be informed by Patient Advisors who are part of our Study Team as well as by oncologists who are actively engaged in the design, implementation and analysis of our study.

描述（由申请人提供）：乳腺癌是美国女性第二常见的癌症，估计在2010年有207,090个新诊断，今天出生的女性中有1例乳腺癌。大多数乳腺癌病例在早期且可治疗的阶段被诊断为早期且可治疗的阶段，其大多数肿瘤（70-80％）是阳性的阳性。对于这些妇女，标准的辅助内分泌治疗是芳香酶抑制剂（AI）疗法，可延长无疾病的生存和时间的疾病。不幸的是，关节疼痛/僵硬/成就是AIS的常见副作用，估计在临床实践中看到的幸存者的联合投诉范围为46％至74％。 AI相关的肌肉骨骼症状（AIMS）的精确病因尚不清楚，并且由于关节炎等老年女性的良性和非特异性肌肉骨骼症状的高流行而变得复杂。由于副作用严重程度而导致的AI停用估计为20-32％，并且在肿瘤学家中非常关注。需要进行研究以确定有效，易于使用，可持续和安全的替代或辅助方法，以便乳腺癌幸存者能够继续进行AI治疗，并具有尽可能无痛的生活。 我们建议调查中度密集型体育锻炼（PA）是否可以在AI疗法中的女性乳腺癌幸存者样本中缓解目标，后者报告中度至重度关节症状。具体而言，我们建议适应和测试关节炎基金会的步行（WWE）计划，该计划是基于循证的，用于减轻关节疼痛，僵硬和疲劳的关节性关节炎，并以自我指导的（非组）形式使用。我们的“概念证明”假设是：（a）适应我们的目标患者人群WWE是可行的，并且（b） 适应的WWE可以为类似于关节炎的成年人的目标患者提供关节疼痛/症状缓解。为了调查这些假设，我们建议：（1）基于对乳腺癌幸存者的访谈（n = 20），以障碍和促进者的身份开发了WWE-颈癌（WWE-BC）的初步适应； （2）对WWE-BC在新的幸存者样本（n = 60）中对（a）进行PA的影响进行初步评估，（a）参与PA，（b）管理关节疼痛/症状，以及（c）剩下的AI治疗； （3）基于与幸存者和肿瘤医生，护士从业者和护士导航员的访谈，制定WWE-BC消息和沟通策略。通过这项研究收集的WWE-BC的可接受性，可行性，安全性和承诺的数据将为一项更大的研究开发，以测试WWE-BC的有效性，确定潜在效应介体和/或主持人，并建立普遍性。我们研究的所有方面都将由我们研究团队的一员以及积极从事我们研究的设计，实施和分析的肿瘤学家的患者顾问告知。

项目成果

Adaptation of an Evidence-Based Arthritis Program for Breast Cancer Survivors on Aromatase Inhibitor Therapy Who Experience Joint Pain.

针对经历关节疼痛的乳腺癌幸存者采用芳香酶抑制剂治疗的循证关节炎计划。

• DOI: 10.5888/pcd12.140535
• 发表时间: 2015
• 期刊: Preventing chronic disease
• 影响因子: 5.5
• 作者: Nyrop,KirstenA;Callahan,LeighF;Rini,Christine;Altpeter,Mary;Hackney,Betsy;Schecher,Arielle;Wilson,Anne;Muss,HymanB
• 通讯作者: Muss,HymanB

Aromatase inhibitor associated arthralgia: the importance of oncology provider-patient communication about side effects and potential management through physical activity.

• DOI: 10.1007/s00520-015-3065-2
• 发表时间: 2016-06
• 期刊: Supportive care in cancer : official journal of the Multinational Association of Supportive Care in Cancer
• 作者: Nyrop KA;Callahan LF;Rini C;Altpeter M;Hackney B;DePue A;Wilson A;Schechter A;Muss HB
• 通讯作者: Muss HB