The Role of Diuretics in Treatment of Aromatase Inhibitors Induced Musculoskeletal Symptoms in Women with Non Metastatic Breast Cancer

Document Type : Research Articles


1 Department of Clinical Oncology and Nuclear Medicine, Faculty of Medicine, Menoufia University, Shebin El kom, Egypt.

2 Department of Rheumatology, Physical Medicine and Rehabilitation, Faculty of Medicine - Menoufia University, Shebin El Kom, Egypt.

3 Department of Clinical Chemistry, National Liver Institute, Menoufia University, Shebin El kom, Egypt.


Background: Around 50% of women receiving Aromatase Inhibitors (AIs) develop musculoskeletal symptoms
which may become severe causing interruption of treatment. Patients with AI-induced arthralgia had higher rates of
joint effusions and fluid in the tendons, so use of diuretics may be helpful. Methods: This prospective phase II study
was conducted in department of clinical oncology and nuclear medicine, Menoufia University Hospital, Egypt, between
Jan. to Dec. 2015. Fifty Women with stage I,II and III breast cancer receiving AIs as adjuvant hormonal treatment
complaining of AIs related musculoskeletal symptoms received Lasilactone® 50 mg tablet; (an oral combination of
Frusemide 20mg/Spironolactone 50 mg), every other day for 4 weeks. Patients were assessed by modified Western
Ontario and McMaster Universities osteoarthritis (WOMAC) index for lower limb and the quick Disabilities of the
Arm, Shoulder and Hand Score (DASH) scoring system for upper limbs, Arabic versions, at baseline and after 4 weeks
of treatment. Results: The mean WOMAC pain score improved significantly (6.0 v 10; P < 0.001), the mean WOMAC
stiffness score improved (2.3 v 3.9; P = 0.002), the mean WOMAC functional score improved (8.7 v 15; P < 0.001),
the total WOMAC score improved (17 v 29; P < 0.001), also a significant difference was noticed for the quick DASH
score; total score (16 v 25; P = 0.02) After use of diuretics for 4 weeks of treatment compared with baseline scores.
Conclusions: The use of diuretics effectively reduces AI related musculoskeletal symptoms with good tolerance


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