Could Vitamin D Help Reduce Musculoskeletal Symptoms in Women With Breast Cancer?

Vitamin D was not associated with a decrease in aromatase inhibitor-associated musculoskeletal symptoms (AIMSS) in women who underwent letrozole treatment for breast cancer, according to the findings of a recent study.

The study included 160 participants with stage I through III breast cancer who were starting adjuvant letrozole and had 25(OH)D levels at 40 ng/ml or below (median age 61 years). All participants received daily 1200 mg calcium and 600 IU vitamin D3 supplements, and were randomly assigned to receive either a placebo or weekly 30,000 IU oral vitamin D supplement. Incidence of AIMSS event was assessed as the primary endpoint. In addition, pain, disability, fatigue, quality of life, 25(OH)D levels, and hand grip strength were assessed at baseline, 12 and 24 weeks after treatment.
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The median 25(OH)D level among participants who received the placebo was 25 ng/ml at baseline, 32 ng/ml at 12 weeks, and 31 ng/ml at 24 weeks. Among participants who received the 30,000 IU vitamin D supplement, the median 25(OH)D was 22 ng/ml at baseline, 53 ng/ml at 12 weeks, and 57 ng/ml at 24 weeks. No serious adverse events were reported in either group.

At 24 weeks, 51% of women who received the placebo experienced an AIMSS event compared with 37% of women who received the 30,000 IU vitamin D supplement. This difference was statistically significant when researchers used the brief pain inventory to assess AIMSS instead of the categorical pain intensity scale, with 56% of women in the placebo group experiencing an AIMSS event compared with 39% in the vitamin D group.

“Although 30,000 IU/week of oral vitamin D3 is safe and effective in achieving adequate vitamin D levels, it was not associated with a decrease in AIMSS events based on the primary endpoint,” the researchers concluded. “Post-hoc analysis using a different tool suggests potential benefit of vitamin D3 in reducing AIMSS.”

—Melissa Weiss

Reference:

Khan QJ, Kimler BF, Reddy PS, et al. Randomized trial of vitamin D3 to prevent worsening of musculoskeletal symptoms in women with breast cancer receiving adjuvant letrozole. The VITAL trial [published online August 2, 2017]. Breast Cancer Res Treat. https://doi.org/10.1007/s10549-017-4429-8.