Table 2.
Self-Reported Prevalence of Adverse Effects From AIs or Tamoxifen and Associations With Discontinuing Endocrine Therapy
| Adverse Effect | Total (N = 538; AIs, 369; Tam, 348) |
Did Not Discontinue (n = 440*; AIs, n = 314; Tam, n = 272) |
Discontinued (n = 98*; AIs, n = 55; Tam, n = 76) |
Odds of Discontinuation† |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % of AI or Tam | % Related to Drug Use | No. | % of AI or Tam | % Related to Drug Use | OR | 95% CI | |
| None | ||||||||||
| AIs | 22 | 6.0 | 17 | 5.4 | N/A | 5 | 9.1 | N/A | N/A | |
| Tam | 21 | 6.0 | 15 | 5.5 | N/A | 6 | 7.9 | N/A | N/A | |
| Individual adverse effects | ||||||||||
| Feeling short of breath | ||||||||||
| AIs | 72 | 19.5 | 64 | 20.4 | 21.9 | 8 | 14.5 | 50.0 | 0.65 | 0.27 to 1.58 |
| Tam | 43 | 12.4 | 33 | 12.1 | 27.3 | 10 | 13.2 | 60.0 | 1.39 | 0.61 to 3.14 |
| Headaches | ||||||||||
| AIs | 62 | 16.8 | 41 | 13.1 | 36.6 | 21 | 38.2 | 61.9 | 3.20 | 1.59 to 6.45‡ |
| Tam | 55 | 15.8 | 36 | 13.2 | 47.2 | 19 | 25.0 | 68.4 | 2.58 | 1.29 to 5.14‡ |
| Cataracts or changes in eyesight | ||||||||||
| AIs | 99 | 26.8 | 87 | 27.7 | 29.9 | 12 | 21.8 | 41.7 | 0.68 | 0.32 to 1.45 |
| Tam | 81 | 23.3 | 65 | 23.9 | 33.9 | 16 | 21.1 | 37.5 | 0.93 | 0.48 to 1.81 |
| Feeling dizzy | ||||||||||
| AIs | 70 | 19.0 | 59 | 18.8 | 61.0 | 11 | 20.0 | 68.8 | 1.24 | 0.56 to 2.78 |
| Tam | 62 | 17.8 | 46 | 16.9 | 50.0 | 16 | 21.1 | 63.6 | 1.74 | 0.87 to 3.50 |
| Aches or pains in joints or muscles | ||||||||||
| AIs | 229 | 62.1 | 196 | 62.4 | 61.2 | 33 | 60.0 | 81.8 | 0.90 | 0.46 to 1.78 |
| Tam | 159 | 45.7 | 127 | 46.7 | 48.0 | 32 | 42.1 | 62.5 | 0.98 | 0.56 to 1.71 |
| Osteoporosis or brittle bones | ||||||||||
| AIs | 92 | 24.9 | 79 | 25.2 | 60.8 | 13 | 23.6 | 53.9 | 0.97 | 0.47 to 2.01 |
| Tam | 50 | 14.4 | 41 | 15.1 | 29.3 | 9 | 11.8 | 22.2 | 0.80 | 0.36 to 1.80 |
| Fracture or broken bone | ||||||||||
| AIs | 34 | 9.2 | 30 | 9.6 | 20.0 | 4 | 7.3 | 75.0 | 0.71 | 0.22 to 2.28 |
| Tam | 22 | 6.3 | 17 | 6.3 | 17.7 | 5 | 6.6 | 100.0 | 0.92 | 0.31 to 2.68 |
| Incontinence | ||||||||||
| AIs | 88 | 23.8 | 72 | 22.9 | 15.3 | 16 | 29.1 | 25.0 | 1.19 | 0.59 to 2.41 |
| Tam | 100 | 28.7 | 81 | 29.8 | 23.5 | 19 | 25.0 | 10.5 | 0.88 | 0.47 to 1.65 |
| Retaining water | ||||||||||
| AIs | 72 | 19.5 | 64 | 20.4 | 48.4 | 8 | 14.5 | 62.5 | 0.65 | 0.27 to 1.54 |
| Tam | 253 | 72.7 | 198 | 72.8 | 42.9 | 55 | 72.4 | 73.3 | 1.34 | 0.68 to 2.67 |
| Depression or changes in mood | ||||||||||
| AIs | 64 | 17.3 | 49 | 15.6 | 40.5 | 15 | 27.3 | 73.3 | 1.14 | 0.57 to 2.29 |
| Tam | 96 | 27.6 | 75 | 27.6 | 38.7 | 21 | 27.6 | 61.9 | 1.24 | 0.67 to 2.28 |
| Insomnia or other sleep problem | ||||||||||
| AIs | 163 | 44.2 | 135 | 43.0 | 37.8 | 28 | 50.9 | 60.7 | 1.52 | 0.81 to 2.85 |
| Tam | 136 | 39.1 | 106 | 39.0 | 40.6 | 30 | 39.5 | 56.7 | 1.11 | 0.63 to 1.94 |
| Feeling tired | ||||||||||
| AIs | 196 | 53.1 | 167 | 53.2 | 47.3 | 29 | 52.7 | 72.4 | 1.05 | 0.56 to 1.99 |
| Tam | 175 | 50.3 | 133 | 48.9 | 46.6 | 42 | 55.3 | 61.9 | 1.77 | 0.99 to 3.18 |
| Loss of appetite, upset stomach or vomiting | ||||||||||
| AIs | 39 | 10.6 | 29 | 9.2 | 55.2 | 10 | 18.2 | 70.0 | 2.05 | 0.84 to 4.97 |
| Tam | 42 | 12.1 | 28 | 10.3 | 53.6 | 14 | 18.4 | 78.6 | 2.45 | 1.14 to 5.28‡ |
| Adverse Effect | Total (N = 538; AIs, 369; Tam, 348) |
Did Not Discontinue (n = 440*; AIs, n = 314; Tam, n = 272) |
Discontinued (n = 95*; AIs, n = 55; Tam, n = 76) |
Odds of Discontinuation† |
||||||
|---|---|---|---|---|---|---|---|---|---|---|
| No. | % | No. | % of AI or Tam | % Related to Drug Use | No. | % of AI or Tam | % Related to Drug Use | OR | 95% CI | |
| Weight gain | ||||||||||
| AIs | 121 | 32.8 | 105 | 33.4 | 67.6 | 16 | 29.1 | 75.0 | 0.89 | 0.45 to 1.78 |
| Tam | 109 | 31.3 | 86 | 31.6 | 33.7 | 23 | 30.3 | 21.7 | 1.12 | 0.61 to 2.04 |
| Breast sensitivity or tenderness | ||||||||||
| AIs | 80 | 21.7 | 67 | 21.3 | 41.8 | 13 | 23.6 | 53.9 | 0.95 | 0.44 to 2.05 |
| Tam | 83 | 23.9 | 66 | 24.3 | 50.0 | 17 | 22.4 | 64.7 | 0.85 | 0.45 to 1.63 |
| Hot flashes | ||||||||||
| AIs | 211 | 57.2 | 185 | 58.9 | 74.6 | 26 | 47.3 | 73.1 | 0.64 | 0.33 to 1.24 |
| Tam | 193 | 55.5 | 157 | 57.7 | 77.1 | 36 | 47.4 | 83.3 | 0.78 | 0.44 to 1.39 |
| Vaginal bleeding, spotting, or discharge | ||||||||||
| AIs | 20 | 5.4 | 17 | 5.4 | 64.7 | 3 | 5.5 | 66.7 | 0.54 | 0.11 to 2.55 |
| Tam | 44 | 12.6 | 38 | 14.0 | 73.7 | 6 | 7.9 | 83.3 | 0.58 | 0.23 to 1.50 |
| Vaginal dryness | ||||||||||
| AIs | 133 | 36.0 | 119 | 37.9 | 49.6 | 14 | 25.5 | 71.4 | 0.42 | 0.20 to 0.86‡ |
| Tam | 106 | 30.5 | 89 | 32.7 | 49.4 | 17 | 22.4 | 52.9 | 0.53 | 0.28 to 0.99‡ |
| Sexual symptoms or loss of sex drive | ||||||||||
| AIs | 133 | 36.0 | 119 | 37.9 | 53.8 | 14 | 25.5 | 57.1 | 0.54 | 0.26 to 1.09 |
| Tam | 106 | 30.5 | 88 | 32.4 | 55.7 | 18 | 23.7 | 55.6 | 0.64 | 0.34 to 1.22 |
| Hair thinning or loss | ||||||||||
| AIs | 128 | 34.7 | 115 | 36.6 | 66.1 | 13 | 23.6 | 69.2 | 0.45 | 0.21 to 0.93‡ |
| Tam | 99 | 28.4 | 82 | 30.1 | 54.9 | 17 | 22.4 | 58.8 | 0.66 | 0.35 to 1.25 |
| Blood clot or thrombosis§ | ||||||||||
| AIs | 10 | 2.7 | 8 | 2.6 | 12.5 | 2 | 3.8 | 50.0 | ||
| Tam | 9 | 2.6 | 5 | 1.9 | 100.0 | 4 | 5.3 | 75.0 | ||
| Stroke§ | ||||||||||
| AIs | 2 | 0.5 | 2 | 0.7 | 100.0 | 0 | 0 | 0 | ||
| Tam | 1 | 0.3 | 0 | 0 | 0 | 1 | 1.4 | 100.0 | ||
| Endometrial, ovarian, or uterine cancer§ | ||||||||||
| AIs | 4 | 1.1 | 4 | 1.3 | 25.0 | 0 | 0 | 0 | ||
| Tam | 6 | 1.7 | 5 | 1.9 | 20.0 | 1 | 1.4 | 100.0 | ||
| Adverse effect combinations | ||||||||||
| Bone related | ||||||||||
| AIs | 114 | 16.5 | 94 | 21.4 | N/A | 14 | 14.3 | N/A | 0.80 | 0.39 to 1.62 |
| Tam | 68 | 9.8 | 51 | 11.6 | N/A | 13 | 13.3 | N/A | 0.92 | 0.46 to 1.86 |
| Sleep related | ||||||||||
| AIs | 251 | 36.2 | 205 | 46.6 | N/A | 37 | 37.8 | N/A | 1.27 | 0.63 to 2.55 |
| Tam | 216 | 31.2 | 161 | 36.6 | N/A | 47 | 48.0 | N/A | 1.43 | 0.79 to 2.56 |
| Hormone/menopause related | ||||||||||
| AIs | 270 | 39.0 | 230 | 52.3 | N/A | 29 | 29.6 | N/A | 0.35 | 0.18 to 0.70‡ |
| Tam | 249 | 35.9 | 202 | 45.9 | N/A | 41 | 41.8 | N/A | 0.45 | 0.24 to 0.83‡ |
Abbreviations: AI, aromatase inhibitor; N/A, not applicable; Tam, tamoxifen.
*
AI and tamoxifen users are not mutually exclusive.
†
Odds of discontinuation are associated with self-reported occurrence of adverse effects, not whether the adverse effect was related to drug use. Adjusted for age and year of diagnosis.
‡
P < .05.
§
Odds ratios were not calculated because of the very low prevalence of women with each adverse effect.