Aromatase inhibitors induced autoimmune disorders in patients with breast cancer: A review

Zarkavelis, George; Kollas, Aristomenes; Kampletsas, Eleftherios; Vasiliou, Vasilis; Kaltsonoudis, Evripides; Drosos, Alexandros A.; Khaled, Hussein M.; Pavlidis, Nicholas

doi:10.1016/j.jare.2016.04.001

Cited by 27 publications

(24 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Variations in autoimmune phenotype across puberty, pregnancy, and menopause demonstrate the complex regulation of immunity by sex hormones. The ease of antagonizing and supplementing these hormones renders them attractive as therapeutic targets and agents, but results have been inconsistent, and exposure to non-physiologic sex hormone levels carries other intrinsic risks (12–14). Thus, identifying and targeting the downstream immunological effectors of sex hormones may hold more therapeutic promise.…”

Section: Sex Hormonesmentioning

confidence: 99%

Sex bias in autoimmunity

Billi¹,

Kahlenberg

Guðjónsson³

2019

Current Opinion in Rheumatology

View full text Add to dashboard Cite

show abstract

Section: Sex Hormonesmentioning

confidence: 99%

Sex bias in autoimmunity

Billi¹,

Kahlenberg

Guðjónsson³

2019

Current Opinion in Rheumatology

View full text Add to dashboard Cite

show abstract

“…Five women receiving either anastrozole, letrozole, or exemestane also developed vasculitis (Table 2) [4][5][6][7][8]. In addition, various other dermatoses have been observed in patients undergoing treatment with aromatase inhibitors (Table 3) [9][10][11][12][13][14][15][16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…The morphology of the other aromatase inhibitor-induced dermatoses-summarized in Table 3 [9-18]-included subacute cutaneous lupus erythematosus (2 women) [9,16], hypersensitivity papular eruption (1 woman-our [11], systemic sclerosis (1 woman) [10], and cutaneous nodulosis (1 woman) [14,19]. The remaining patients' clinical presentation was designated either a grade 2 (1 woman) [13] or a grade 3 (1 woman) [18] skin reaction.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Anastrozole-Induced Dermatitis: Report of a Woman with an Anastrozole-Associated Dermatosis and a Review of Aromatase Inhibitor-Related Cutaneous Adverse Events

Kim

Cohen

2020

Dermatol Ther (Heidelb)

View full text Add to dashboard Cite

Anastrozole is an aromatase inhibitor. Anastrozole competitively inhibits the aromatase enzyme, which synthesizes estrogen. It is used for estrogen receptor-positive breast cancers. A woman with breast cancer and anastrozole-induced dermatitis is described; the cutaneous side effects associated with aromatase inhibitors are also reviewed. Skin-related adverse events associated with aromatase inhibitor use are uncommon and may be delayed in appearance; the time of onset ranges from less than 5 days to 6 months (median 2 months). They present as either vasculitis, erythema nodosum, subacute cutaneous lupus erythematosus, or other dermatoses. Some patients demonstrate cutaneous lesions at either the original site of the breast malignancy or in areas that were previously treated with surgery or radiotherapy. The skin reactions are usually treated with discontinuation of the aromatase inhibitor; topical corticosteroids or oral corticosteroids or both are also used for some patients. Our patient's drug reaction occurred 2 months after starting the anastrozole and improved after a course of oral and topical corticosteroids. She was able to be switched to an alternate aromatase inhibitor without a recurrence of her adverse skin reaction.

show abstract

“…AI are used as first-line adjuvant hormonal therapy in postmenopausal women with hormone-receptor positive breast cancer [ 3 ]. Over the past 10 years, there have been reported cases of hepatitis and autoimmune diseases resulting from AI use [ 4 , 5 ]. We report a rare case of letrozole-induced hepatitis with autoimmune features.…”

Section: Introductionmentioning

confidence: 99%

Letrozole-induced hepatitis with autoimmune features: a rare adverse drug reaction with review of the relevant literature

Gharia

Seegobin

Maharaj

et al. 2017

Oxford Medical Case Reports

View full text Add to dashboard Cite

While aromatase inhibitors (AIs) have been known to cause minor elevations in liver enzymes, severe hepatotoxicity is rare. To the best of our knowledge, this is the first reported case of Letrozole-induced hepatitis with autoimmune features. A 70-year-old female with estrogen positive, invasive ductal carcinoma of the breast, presented with jaundice 3 months after starting letrozole. Hepatic transaminases were markedly elevated and her ANA and anti-smooth muscle antibody was positive. Liver biopsy featured drug-induced hepatitis. After stopping letrozole, liver tests trended back to normal within 3 weeks. She scored 9 for Roussel-Uclaf Causality Assessment Method (RUCAM). Over the last 10 years, there have been reported cases of drug-induced hepatitis secondary to AIs. We anticipate that there will be more widespread use of AIs based on recommendations from the TEXT, SOFT and extended AI trials. Therefore, physicians must be aware of this rare but life-threatening complication.

show abstract

Aromatase inhibitors induced autoimmune disorders in patients with breast cancer: A review

Abstract: Graphical abstract

Cited by 27 publications

References 45 publications

Sex bias in autoimmunity

Sex bias in autoimmunity

Anastrozole-Induced Dermatitis: Report of a Woman with an Anastrozole-Associated Dermatosis and a Review of Aromatase Inhibitor-Related Cutaneous Adverse Events

Letrozole-induced hepatitis with autoimmune features: a rare adverse drug reaction with review of the relevant literature

Contact Info

Product

Resources

About