Kubo, M., Onishi, H., Kuroki, S., Okido, M., Shimada, K., Yokohata, K., . . . Katano, M. (2012). Short-term and low-dose prednisolone administration reduces aromatase inhibitor–induced arthralgia in patients with breast cancer. Anticancer Research, 32, 2331–2336.

To determine whether short-term and low-dose prednisolone reduces aromatase inhibitor (AI)–induced arthralgias in patients with breast cancer

Prednisolone 5 mg was administered to women once daily in the morning for one week.

• The study reported on a sample of 27 patients.
• Mean patient age was 62.8 years, with a range of 51–81 years.
• All patients were hormone receptor–positive women with breast cancer.
• Of the sample, 25 were taking anastrazole, and 2 were taking letrozole; 68% had finger pain, and 29% had knee joint pain.

• Multisite
• Outpatient setting
• Japan

Patients were undergoing active antitumor treatment.

The study was a prospective intervention clinical trial.

• Questionnaire for assessment of arthralgia symptoms (no mention of validation); symptoms were measured at one week, one month, and two months.
• A visual analog scale also was used to measure percentage of relief.

Joint symptoms improved in 67% of patients immediately after prednisolone, 63% continued to report relief at one month, and 52% at two months. Thirty percent of patients reported an improvement in daily life at one week and one month and 26% at two months.

Results suggest that a low dose of 5 mg of prednisolone given for one week at the initiation of AI therapy can relieve arthralgias in some patients.

• The study had a small sample, with less than 30 participants.     
• The study had baseline sample/group differences of import (two patients on letrozole and others on anastrozole).     
• The study had risk of bias due to no control group.
• Measurement/methods were not well described.  
• Measurement validity/reliability were questionable.
• Adverse effects were not delineated.

While this study suggests that AI-related pain can be reduced in patients with breast cancer using prednisolone, randomized controlled trials are needed that reflect longer follow-up and adverse event monitoring. Insufficient evidence exists to recommend practice implementation.