{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,14]],"date-time":"2026-03-14T08:01:36Z","timestamp":1773475296410,"version":"3.50.1"},"reference-count":30,"publisher":"MDPI AG","issue":"2","license":[{"start":{"date-parts":[[2020,2,19]],"date-time":"2020-02-19T00:00:00Z","timestamp":1582070400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Stephen\u2019s Fund, University of Arizona Arthritis Center","award":["102-2628-B-006-003-MY3"],"award-info":[{"award-number":["102-2628-B-006-003-MY3"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Tamoxifen or aromatase inhibitor (AI) therapy may prevent breast cancer recurrence, however, adverse effects may lead to treatment discontinuation. Evidence regarding the occurrence of AI-associated musculoskeletal problems among Asians is scarce. We identified women with breast cancer-initiating tamoxifen or AIs from the Taiwan National Health Insurance Research Database (2007\u20132012). Using multivariable cause-specific hazard models, we examined the association between endocrine therapy and the risk of any arthritis and carpal tunnel syndrome, adjusting for age, prior cancer treatment, and other health status factors. Among 32,055 eligible women with breast cancer (mean age = 52.6 \u00b1 11.5 years), 87.4% initiated tamoxifen, 3.9% initiated anastrozole, 8.0% initiated letrozole, and 0.7% initiated exemestane. AI users had a higher 1-year cumulative incidence for any arthritis (13.0% vs. 8.2%, p &lt; 0.0001) and carpal tunnel syndrome (1.4% vs. 0.8%, p = 0.008). Compared to tamoxifen users, AI users had a higher risk of any arthritis [adjusted hazard ratio (aHR) = 1.21, 95%CI = 1.09\u20131.34] and carpal tunnel syndrome (aHR = 1.68, 95%CI = 1.22\u20132.32). No significant difference was observed in the risks of any arthritis and carpal tunnel syndrome across different AIs. Taxane use was not associated with any arthritis (aHR = 0.92, 95%CI = 0.81\u20131.05) or carpal tunnel syndrome (aHR = 0.97, 95%CI = 0.67\u20131.40) compared to other chemotherapies. Taiwanese women with breast cancer-initiating AIs had an increased risk of arthritis and carpal tunnel syndrome compared to those who initiated tamoxifen.<\/jats:p>","DOI":"10.3390\/jcm9020566","type":"journal-article","created":{"date-parts":[[2020,2,25]],"date-time":"2020-02-25T08:12:22Z","timestamp":1582618342000},"page":"566","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":17,"title":["Aromatase Inhibitors and Risk of Arthritis and Carpal Tunnel Syndrome among Taiwanese Women with Breast Cancer: A Nationwide Claims Data Analysis"],"prefix":"10.3390","volume":"9","author":[{"given":"Hsu-Chih","family":"Chien","sequence":"first","affiliation":[{"name":"Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine and Health Outcome Research Center, National Cheng Kung University, Tainan 701, Taiwan"},{"name":"School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"},{"name":"Division of Rheumatology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA"},{"name":"University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yea-Huei","family":"Kao Yang","sequence":"additional","affiliation":[{"name":"Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine and Health Outcome Research Center, National Cheng Kung University, Tainan 701, Taiwan"},{"name":"School of Pharmacy, College of Medicine, National Cheng Kung University, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"C. Kent","family":"Kwoh","sequence":"additional","affiliation":[{"name":"Division of Rheumatology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA"},{"name":"University of Arizona Arthritis Center, University of Arizona College of Medicine, Tucson, AZ 85724, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pavani","family":"Chalasani","sequence":"additional","affiliation":[{"name":"Division of Hematology and Oncology, College of Medicine, University of Arizona, Tucson, AZ 85724, USA"},{"name":"University of Arizona Cancer Center, Tucson, AZ 85719, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1640-5497","authenticated-orcid":false,"given":"Debbie L.","family":"Wilson","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes &amp; Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6590-4770","authenticated-orcid":false,"given":"Wei-Hsuan","family":"Lo-Ciganic","sequence":"additional","affiliation":[{"name":"Department of Pharmaceutical Outcomes &amp; Policy, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA"},{"name":"Center for Drug Evaluation and Safety, College of Pharmacy, University of Florida, Gainesville, FL 32610, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2020,2,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"E359","DOI":"10.1002\/ijc.29210","article-title":"Cancer incidence and mortality worldwide: Sources, methods and major patterns in GLOBOCAN 2012. 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