Aromatase Inhibitors and Plasma Lipid Changes in Postmenopausal Women with Breast Cancer: A Systematic Review and Meta-Analysis

• Published in: Journal of clinical medicine Vol. 13; no. 6; p. 1818
• Main Authors: Bérczi, Bálint, Farkas, Nelli, Hegyi, Péter, Tóth, Barbara, Csupor, Dezső, Németh, Balázs, Lukács, Anita, Czumbel, László Márk, Kerémi, Beáta, Kiss, István, Szabó, Andrea, Varga, Gábor, Gerber, Gábor, Gyöngyi, Zoltán
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 21.03.2024; MDPI
• Subjects: Algorithms; Analysis; Blood cholesterol; Breast cancer; Cancer; Cardiac patients; Care and treatment; Cholesterol; Development and progression; Diagnosis; Drug therapy; Dyslipidemias; Estrogen; Estrogens; High density lipoprotein; Keywords; Libraries; Lipids; Medical research; Medicine, Experimental; Meta-analysis; Metabolic disorders; Postmenopausal women; Prevention; Risk factors; Science; Systematic Review; Tamoxifen; Womens health; Hungary; United States > US; letrozole; meta-analysis; breast cancer; exemestane; lipids; anastrozole
• ISSN: 2077-0383; 2077-0383
• DOI: 10.3390/jcm13061818

Background: Women are typically diagnosed with estrogen receptor-positive breast cancer around the postmenopausal period when declining estrogen levels initiate changes in lipid profiles. Aromatase inhibitors (AI) are used to prevent the progression of cancer; however, a further reduction in estrogen levels may have detrimental effects on lipid levels, which was our working hypothesis. Methods: Our meta-analysis was conducted on the lipid profiles of postmenopausal breast cancer patients at baseline and at different treatment time points. Results: We identified 15 studies, including 1708 patients. Studies using anastrozole (ANA), exemestane (EXE), letrozole (LET), and tamoxifen (TMX) were involved. Subgroup analyses revealed that 3- and 12-month administrations of LET and EXE lead to negative changes in lipid profiles that tend to alter the lipid profile undesirably, unlike ANA and TMX. Conclusions: Our results suggest that, despite statistically significant results, EXE and LET may not be sufficient to cause severe dyslipidemia in patients without cardiovascular comorbidities according to the AHA/ACC Guideline on the Management of Blood Cholesterol. However, the results may raise the question of monitoring the effects of AIs in patients, especially those with pre-existing cardiovascular risk factors such as dyslipidemia.