Download PDF
Homeopathy 2016; 105(04): 299-308
DOI: 10.1016/j.homp.2016.05.004
Original Paper
Copyright © The Faculty of Homeopathy 2016

Treatment with Ruta graveolens 5CH and Rhus toxicodendron 9CH may reduce joint pain and stiffness linked to aromatase inhibitors in women with early breast cancer: results of a pilot observational study

Jean-Claude Karp
1   Centre Hospitalier de Troyes, 101, Avenue Anatole France, 10000 Troyes, France
,
Carole Sanchez
2   Cabinet Médical, 7 bis rue du Chêne, 10430 Rosières Près Troyes, France
,
Philippe Guilbert
3   Institut Jean Godinot, 1 rue du général Koenig, CS 80014, 51056 Reims, France
,
William Mina
1   Centre Hospitalier de Troyes, 101, Avenue Anatole France, 10000 Troyes, France
,
Antoine Demonceaux
4   Cabinet Médical, 21, Place du Chapitre, 51100 Reims, France
,
Hervé Curé
3   Institut Jean Godinot, 1 rue du général Koenig, CS 80014, 51056 Reims, France
› Author Affiliations
Subject Editor:
Further Information

Publication History

Received10 December 2015
revised24 March 2016

accepted23 May 2016

Publication Date:
22 December 2017 (online)

    Permissions and Reprints

Objective: To determine the possible effect of two homeopathic medicines, Ruta graveolens 5CH and Rhus toxicodendron 9CH, in the prevention of aromatase inhibitor (AI) associated joint pain and/or stiffness in women with early, hormone-receptor positive, breast cancer.

Methods: This prospective, unrandomized observational study was carried out between April and October 2014. Women were recruited in two groups, according to which of the two study centres they attended: one receiving homeopathy in addition to standard treatment (group H) and a control group, receiving standard treatment (group C). All women were treated with an AI. In addition, women in group H also took Ruta graveolens 5CH and Rhus toxicodendron 9CH (5 granules, twice a day) up to 7 days before starting AI treatment. The homeopathic medicines were continued for 3 months. Demographic and clinical data were recorded using a self-assessment questionnaire at inclusion (T0) and 3 months (T3). Primary evaluation criteria were the evolution of scores for joint pain and stiffness, the impact of pain on sleep and analgesic consumption in the two groups after 3 months of treatment.

Results: Forty patients (mean age 64.9 ± 8.1 years) were recruited, 20 in each group. Two-thirds of the patients had joint pain before starting AI treatment. There was a significant difference in the evolution of mean composite pain score between T0 and T3 in the two groups (−1.3 in group H vs. +3.4 in group C; p = 0.0001). The individual components of the pain score (frequency, intensity and number of sites of pain) also decreased significantly in group H. Nine patients in group C (45%) vs. 1 (5%) in group H increased their analgesic consumption between T0 and T3 (p = 0.0076). After 3 months of treatment, joint pain had a worse impact on sleep in patients in group C (35% vs. 0% of patients; p = 0.0083). The differences observed in the evolution of morning and daytime stiffness between the two groups were smaller (p = 0.053 and p = 0.33, respectively), with the exception of time necessary for the disappearance of morning stiffness which was greater in group C (37.7 ± 23.0 vs. 17.9 ± 20.1 min; p = 0.0173).

Conclusion: These preliminary results suggest that treatment with Ruta graveolens 5CH and Rhus toxicodendron 9CH may decrease joint pain/stiffness in breast cancer patients treated with AIs. A larger-scale randomized study is required to confirm these results.

Keywords

Aromatase inhibitor - Breast cancer - Homeopathy - Joint pain - Joint stiffness
 

  • References

  • 1 Ferlay J., Steliarova-Foucher E., Lortet-Tieulent J. et al. Reprint of: cancer incidence and mortality patterns in Europe: estimates for 40 countries in 2012. Eur J Cancer 2015; 51: 1201-1202.
    CrossrefPubMedGoogle Scholar
  • 2 Siegel R., Naishadham D., Jemal A. Cancer statistics. CA Cancer J Clin 2012 (62) 2012; 10-29.
    PubMedGoogle Scholar
  • 3 Burstein H.J., Prestrud A.A., Seidenfeld J. et al. American Society of Clinical Oncology American Society of Clinical Oncology clinical practice guideline: update on adjuvant endocrine therapy for women with hormone receptor-positive breast cancer. J Clin Oncol 2010; 28: 3784-3796.
    CrossrefPubMedGoogle Scholar
  • 4 Wildiers H., Kunkler I., Biganzoli L. et al. International Society of Geriatric Oncology. Management of breast cancer in elderly individuals: recommendations of the International Society of Geriatric Oncology. Lancet Oncol 2007; 8: 1101-1115.
    CrossrefPubMedGoogle Scholar
  • 5 Hershman D.L., Loprinzi C., Schneider B.P. Symptoms: aromatase inhibitor induced arthralgias. Adv Exp Med Biol 2015; 862: 89-100.
    PubMedGoogle Scholar
  • 6 Burstein H.J. Aromatase inhibitor-associated arthralgia syndrome. Breast 2007; 16: 223-234.
    CrossrefPubMedGoogle Scholar
  • 7 Donnellan P.P., Douglas S.L., Cameron D.A., Leonard R.C. Aromatase inhibitors and arthralgia. J Clin Oncol 2001; 19: 2767.
    CrossrefPubMedGoogle Scholar
  • 8 Felson D.T., Cummings S.R. Aromatase inhibitors and the syndrome of arthralgias with estrogen deprivation. Arthritis Rheum 2005; 52: 2594-2598.
    CrossrefPubMedGoogle Scholar
  • 9 Moscetti L., Fabbri M.A., Sperduti I. et al. Adjuvant aromatase inhibitor therapy in early breast cancer: what factors lead patients to discontinue treatment?. Tumori 2015. 0(0): 0. [Epub ahead of print].
    Google Scholar
  • 10 Baum M., Buzdar A., Cuzick J. et al. ATAC (Arimidex, Tamoxifen Alone or in Combination) Trialists' Group Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early-stage breast cancer: results of the ATAC (Arimidex, Tamoxifen Alone or in Combination) trial efficacy and safety update analyses. Cancer 2003; 98: 1802-1810.
    CrossrefPubMedGoogle Scholar
  • 11 Crew K.D., Greenlee H., Capodice J. et al. Prevalence of joint symptoms in postmenopausal women taking aromatase inhibitors for early-stage breast cancer. J Clin Oncol 2007; 25: 3877-3883.
    CrossrefPubMedGoogle Scholar
  • 12 Goss P.E., Ingle J.N., Martino S. et al. A randomized trial of letrozole in postmenopausal women after five years of tamoxifen therapy for early-stage breast cancer. N Engl J Med 2003; 349: 1793-1802.
    CrossrefPubMedGoogle Scholar
  • 13 Baum M., Budzar A.U., Cuzick J. et al. ATAC Trialists' Group Anastrozole alone or in combination with tamoxifen versus tamoxifen alone for adjuvant treatment of postmenopausal women with early breast cancer: first results of the ATAC randomised trial. Lancet 2002; 359: 2131-2139.
    CrossrefPubMedGoogle Scholar
  • 14 Mao J.J., Stricker C., Bruner D. et al. Patterns and risk factors associated with aromatase inhibitor-related arthralgia among breast cancer survivors. Cancer 2009; 115: 3631-3639.
    CrossrefPubMedGoogle Scholar
  • 15 Coxib and traditional NSAID Trialists' (CNT) Collaboration Bhala N., Emberson J., Merhi A. et al. Vascular and upper gastrointestinal effects of non-steroidal anti-inflammatory drugs: meta-analyses of individual participant data from randomised trials. Lancet 2013; 382: 769-779.
    CrossrefPubMedGoogle Scholar
  • 16 Conaghan P.G. A turbulent decade for NSAIDs: update on current concepts of classification, epidemiology, comparative efficacy, and toxicity. Rheumatol Int 2012; 32: 1491-1502.
    CrossrefPubMedGoogle Scholar
  • 17 Brune K., Patrignani P. New insights into the use of currently available non-steroidal anti-inflammatory drugs. J Pain Res 2015; 8: 105-118.
    PubMedGoogle Scholar
  • 18 Nyrop K.A., Callahan L.F., Rini C. et al. Adaptation of an evidence-based arthritis program for breast cancer survivors on aromatase inhibitor therapy who experience joint pain. Prev Chronic Dis 2015; 12: E91.
    PubMedGoogle Scholar
  • 19 Nyrop K.A., Muss H.B., Hackney B., Cleveland R., Altpeter M., Callahan L.F. Feasibility and promise of a 6-week program to encourage physical activity and reduce joint symptoms among elderly breast cancer survivors on aromatase inhibitor therapy. J Geriatr Oncol 2014; 5: 148-155.
    CrossrefPubMedGoogle Scholar
  • 20 Galantino M.L., Greene L., Archetto B. et al. A qualitative exploration of the impact of yoga on breast cancer survivors with aromatase inhibitor-associated arthralgias. Explore (NY) 2012; 8: 40-47.
    CrossrefPubMedGoogle Scholar
  • 21 Coleman R.E., Bolten W.W., Lansdown M. et al. Aromatase inhibitor-induced arthralgia: clinical experience and treatment recommendations. Cancer Treat Rev 2008; 34: 275-282.
    CrossrefPubMedGoogle Scholar
  • 22 Chim K., Xie S.X., Stricker C.T. et al. Joint pain severity predicts premature discontinuation of aromatase inhibitors in breast cancer survivors. BMC Cancer 2013; 13: 401.
    CrossrefPubMedGoogle Scholar
  • 23 Huh Y.H., Kim M.J., Yeo M.G. Homeopathic Rhus toxicodendron treatment increased the expression of cyclooxygenase-2 in primary cultured mouse chondrocytes. Homeopathy 2013; 102: 248-253.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 24 Patel D.R., Ansari I.A., Kachchhi Y.N. et al. Toxicodendron pubescens retains its anti-arthritic efficacy at 1M, 10M and CM homeopathic dilutions. Homeopathy 2012; 101: 165-170.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 25 Patil C.R., Rambhade A.D., Jadhav R.B. et al. Modulation of arthritis in rats by Toxicodendron pubescens and its homeopathic dilutions. Homeopathy 2011; 100: 131-137.
    Article in Thieme ConnectPubMedGoogle Scholar
  • 26 Fisher P., Greenwood A., Huskisson E.C., Turner P., Belon P. Effect of homeopathic treatment on fibrositis (primary fibromyalgia). BMJ 1989; 299: 365-366.
    CrossrefPubMedGoogle Scholar
  • 27 Punglia R.S., Hughes K.S., Muss H.B. Management of older women with early-stage breast cancer. Am Soc Clin Oncol Educ Book 2015; 35: 48-55.
    CrossrefPubMedGoogle Scholar
  • 28 Muslimani A.A., Spiro T.P., Chaudhry A.A., Taylor H.C., Jaiyesimi I., Daw H.A. Aromatase inhibitor-related musculoskeletal symptoms: is preventing osteoporosis the key to eliminating these symptoms?. Clin Breast Cancer 2009; 9: 34-38.
    CrossrefPubMedGoogle Scholar
  • 29 Sestak I., Cuzick J., Sapunar F. et al. ATAC Trialists' Group Risk factors for joint symptoms in patients enrolled in the ATAC trial: a retrospective, exploratory analysis. Lancet Oncol 2008; 9: 866-872.
    CrossrefPubMedGoogle Scholar
  • 30 Buettner C., Kroenke C.H., Phillips R.S. et al. Correlates of use of different types of complementary and alternative medicine by breast cancer survivors in the nurses' health study. Breast Cancer Res Treat 2006; 100: 219-227.
    CrossrefPubMedGoogle Scholar
  • 31 Gibson R.G., Gibson S.L., MacNeill A.D., Buchanan W.W. Homoeopathic therapy in rheumatoid arthritis: evaluation by double-blind clinical therapeutic trial. Br J Clin Pharmacol 1980; 9: 453-459.
    CrossrefPubMedGoogle Scholar
  • 32 Bell I.R., Lewis 2nd D.A., Brooks A.J. et al. Improved clinical status in fibromyalgia patients treated with individualized homeopathic remedies versus placebo. Rheumatology (Oxford) 2004; 43: 577-582.
    CrossrefPubMedGoogle Scholar
  • 33 Boehm K., Raak C., Cramer H., Lauche R., Ostermann T. Homeopathy in the treatment of fibromyalgia–a comprehensive literature-review and meta-analysis. Complement Ther Med 2014; 22: 731-742.
    CrossrefPubMedGoogle Scholar
  • 34 Saghatchian M., Bihan C., Chenailler C., Mazouni C., Dauchy S., Delaloge S. Exploring frontiers: use of complementary and alternative medicine among patients with early-stage breast cancer. Breast 2014; 23: 279-285.
    CrossrefPubMedGoogle Scholar
  • 35 Simon L., Prebay D., Beretz A. et al. Complementary and alternative medicines taken by cancer patients. Bull Cancer 2007; 94: 483-488. [Article in French].
    PubMedGoogle Scholar
  • 36 Mathelin C., Bagot J.L. L'utilisation des médecines complémentaires et des soins de support par les patientes atteintes d'un cancer mammaire. Gynecol Obstet Fertil 36 (03) 2008; Mar 245-247.
    CrossrefPubMedGoogle Scholar
  • 37 Brien S., Lachance L., Prescott P., McDermott C., Lewith G. Homeopathy has clinical benefits in rheumatoid arthritis patients that are attributable to the consultation process but not the homeopathic remedy: a randomized controlled clinical trial. Rheumatology (Oxford) 2011; 50: 1070-1082.
    CrossrefPubMedGoogle Scholar