Variations in Incidence of Trigger Finger and Response to Corticosteroid Injection after Aromatase Inhibitor Therapy for Breast Cancer

Introduction: Aromatase inhibitors (AI), such as letrozole and anastrozole, have been demonstrated to have significant musculoskeletal symptoms in patients. The purpose of this study was to evaluate specific AI medications effect on the incidence of trigger finger and independent factors affecting treatment outcomes within this population.

Methods: A retrospective chart review was performed at our institution between the years 2014-2018 in patients with the diagnosis of breast cancer. This cohort was then sorted based on medication regimens, trigger finger diagnosis, steroid injections, and need for surgical release of trigger finger.

Results: A total of 15, 144 patients were included for initial review. The overall rate of trigger finger diagnosis was 2.75% in entire breast cancer population and 4.5% for patients receiving AI therapy. Patients taking letrozole and anastrozole had an increased odds ratio of 2.0 and 1.7 respectively for developing trigger finger. Patients that switched between letrozole and anastrozole during treatment had a higher rate of failed steroid injection treatment (45.2% vs. 23.5%, p=.021). Among patients receiving AI treatment diagnosed with trigger finger, diabetics and a hemoglobin A1c greater than 6.5 were associated with significantly increased rates of failed steroid therapy.

Conclusion: Patients receiving AI therapy have an increased incidence of trigger finger. The outcomes of treatment is equivalent between AI and non-AI trigger finger populations. However, patients that require switching of regimens due to significant musculoskeletal symptoms are more likely to fail steroid therapy. Poorly controlled diabetes was also an independent factor for compromised steroid treatment of trigger finger.

Comments：

This is a retrospective study that found a higher incidence of trigger finger in patients receiving aromatase inhibitor (AI) therapy for breast cancer. The study also found that patients who switched AI medications and those with poorly controlled diabetes had an increased rate of failed steroid therapy for trigger finger.

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Cat.No.	Product Name	Information
S1235	Letrozole	Letrozole is a third generation inhibitor of aromatase with IC50 of 0.07-20 nM in cell-free assays.It has no effect on the plasma levels of 17α-OH progesterone, thyroid-stimulating hormone (TSH), luteinizing hormone (LH), follicle-stimulating hormone (FSH), or androstenedione and does not affect normal urine electrolyte excretion or thyroid function in clinical studies. Letrozole induces autophagy.

Related Targets

Aromatase Autophagy