Red Wine as an Aromatase Inhibitor: A Narrative Review

A perfect balance between the various approaches should be achieved when treating breast cancer. Surgery, neoadjuvant and adjuvant chemotherapy, endocrine therapy, targeted therapy, and other methods are available in the therapeutic armamentarium of modern oncologists. https://fiestavietnam.com/the-contribution-of-steroids-to-building-lean/ Specifically, endocrine therapy with selective estrogen receptor (ER) modulators (SERMs), such as tamoxifen (TAM) and aromatase inhibitors (AIs), is currently central to the treatment of hormone receptor-positive breast cancer (3–6). Breast cancer (BC) is a leading cause of premature death in women and the most expensive malignancy to treat. Since the introduction of targeted therapies has resulted in changes to BC therapy practices, health economic evaluations have become more important in this area.

Aromatase inhibitors–socioeconomical issues

The mean age of subjects at the time of breast cancer (BC) diagnosis in our study was 61 years. The majority of the study cohort was non-Hispanic white (59.9%) and had commercial insurance (88.5%). The median copayment was higher for the BAI ($33.3) than for the GAI group ($9.04). Of the patients in this cohort, 39% had copayments under $15, and 29% had copayments over $30 per month.

The authors even stated that they could not find any determining difference between the study arms when looking at myocardial infarction rates, osteoporosis or fracture, and cerebrovascular events at the long-term follow-up. In summary, this study demonstrated that initial letrozole can offer continued and slightly attenuated benefits compared with TAM in postmenopausal women with hormone-responsive early breast cancer (35). Regarding patients with locally advanced and metastatic endocrine-responsive postmenopausal breast cancer, a meta-analysis of phase III randomized controlled trials comparing first-line endocrine therapy with third-generation AIs and TAM was reported in the literature. This study examined OS and addressed whether the progression-free survival (PFS) benefit of AI therapy results from a reduction in de novo resistance or a delay in acquired resistance to endocrine therapy.

In contrast, the PFS was statistically significantly different between the two groups in favor of AIs. Finally, even after excluding letrozole from the data, OS did not significantly differ between the two arms. The study concludes that, in the first-line setting, the choice of an AI instead of TAM has a significant clinical benefit as it increases the duration of tumor control by prolonging the PFS (12). The literature offers various trials that compare AIs and TAM in adjuvant endocrine therapy (AET) (18–26). The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) meta-analysis was released in 2015 to clarify the relative benefits of AIs vs. TAM and the outcomes of scheduling these two drugs differently during the 5 years of AET (27).

Aromatase inhibitors are delivered in tablet form and prescribed as a once-daily dose. Aromasin should be taken after a meal as fat in food aids in the drug’s absorption. The administrative and outpatient/inpatient utilization and diagnosis files were used to determine patient characteristics, health plan enrollment status, prevalent and incident comorbidities. Geocoded census data was used to determine education and covariant data and death files were used to determine cause and date of death. The author(s) declare financial support was received for the research, authorship, and/or publication of this article. Editorial assistance was provided by Ethos through an unconditional grant by Accord.

• However, it noted that independent-review results are usually more conservative than investigator assessment, which was not the case in MONARCH 3.
• However, these studies treated all alcoholic beverages as equivalents and did not differentiate between red and white wine or compare red to white wine; thus, it is possible that red wine had a beneficial effect that was masked by this study design 31.
• However, the clinical benefit of these therapies is limited, and the prevention and management of GSM is largely unsolved (Biglia et al., 2015; Cook et al., 2017).
• Membership and provider records are linked to pharmacy claims (OptumRx) and medical claims, including diagnosis and procedure codes (CPT, HCPCS, as well as ICD9 procedures) with their dates of service and providers.

Structural Uncertainty

Policymakers need robust evidence on the cost-effectiveness of different treatment options to base decisions on how best to use scarce healthcare resources. For a summary of research studies on aromatase inhibitors and early breast cancer,visit the Breast Cancer Research Studies section. Many costs for cancer treatment are tax deductible, including the out-of-pocket cost of hormone therapy medications. Below are the pre-insurance, U.S. prices for a month’s supply (30 days) of the brand name and generic versions of tamoxifen and aromatase inhibitors.

Hormone receptor status and hormone therapy

We utilized a large database with a nationwide sample, including patients with a wide variety of prescription benefit plans, allowing for a diversity of copayment amounts, income, and age. This study also compared changes in adherence and discontinuation rates after the introduction of generic AIs, providing support that lower out-of-pocket costs for drugs with similar effectiveness can improve compliance. In addition, we evaluated a timeframe in which generic aromatase inhibitors were introduced to the market so we could see how this change in availability affected adherence rates. Furthermore, in addition to copayment amount and type of therapy, the dataset has information on patient income, insurance type, and deductible amount. AIs are generally considered cost-effective compared to tamoxifen in estrogen receptor-positive breast cancer. The overall quality of the included studies was between high and average but characterizing heterogeneity, and distributional effects should be considered in any future economic evaluation studies of AIs.