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Patients receiving ARIMIDEX had an increase in joint disorders (including arthritis, arthrosis and arthralgia) compared with patients receiving tamoxifen, provibol 25 mg oral steroids proviron. Patients receiving ARIMIDEX had an increase in the incidence of all fractures (specifically fractures of spine, hip and wrist) [315 (10%)] compared with patients receiving tamoxifen [209 (7%)]. Patients receiving ARIMIDEX had a higher incidence of carpal tunnel syndrome [78 (2. Vaginal bleeding occurred more frequently in the tamoxifen-treated patients versus the ARIMIDEX-treated patients 317 (10%) versus 167 (5%), respectively. Patients receiving ARIMIDEX had a lower incidence of hot flashes, vaginal bleeding, vaginal discharge, endometrial cancer, venous thromboembolic events and ischemic cerebrovascular events compared with patients receiving tamoxifen. Results are consistent with the previous analyses. Serious adverse reactions were similar between ARIMIDEX (50%) and tamoxifen (51%). Cardiovascular events were consistent with the known safety profiles of ARIMIDEX and tamoxifen. The cumulative incidences of all first fractures (both serious and non-serious, occurring either during or after treatment) was higher in the ARIMIDEX group (15%) compared to the tamoxifen group (11%). This increased first fracture rate during treatment did not continue in the post-treatment follow-up period. The cumulative incidence of new primary cancers was similar in the ARIMIDEX group (13. Consistent with the previous analyses, endometrial cancer was higher in the tamoxifen group (0. The overall number of deaths (during or off-trial treatment) was similar between the treatment groups. There were more deaths related to breast cancer in the tamoxifen than in the ARIMIDEX treatment group. Adverse reactions occurring with an incidence of at least 5% in either treatment group of trials 0030 and 0027 during or within 2 weeks of the end of treatment are shown in Table 3. Table 3 : Adverse Reactions Occurring with an Incidence of at Least 5% in Trials 0030 and 0027 Body system Adverse Reaction* Number (%) of subjects ARIMIDEX (N=506) Tamoxifen (N=511) Whole body Asthenia 83 (16) 81(16) Pain 70(14) 73 (14) Back pain 60(12) 68 (13) Headache 47 (9) 40 (8) Abdominal pain 40 (8) 38 (7) Chest pain 37 (7) 37 (7) Flu syndrome 35 (7) 30 (6) Pelvic pain 23 (5) 30 (6) Cardiovascular Vasodilation 128 (25) 106 (21) Hypertension 25 (5) 36 (7) Digestive Nausea 94 (19) 106 (21) Constipation 47 (9) 66 (13) Diarrhea 40 (8) 33 (6) Vomiting 38 (8) 36 (7) Anorexia 26 (5) 46 (9) Metabolic and Nutritional Peripheral edema 51 (10) 41 (8) Musculoskeletal Bone pain 54 (11) 52 (10) Nervous Dizziness 30 (6) 22 (4) Insomnia 30 (6) 38 (7) Depression 23 (5) 32 (6) Hypertonia 16 (3) 26 (5) Respiratory Cough increased 55 (11) 52 (10) Dyspnea 51 (10) 47 (9) Pharyngitis 49 (10) 68 (13) Skin and appendages Rash 38 (8) 34 (8) Urogenital Leukorrhea 9 (2) 31 (6) * A patient may have had more than 1 adverse event. Less frequent adverse experiences reported in patients receiving ARIMIDEX l mg in either Trial 0030 or Trial 0027 were similar to those reported for second-line therapy. Based on results from second-line therapy and the established safety profile of tamoxifen, the incidences of 9 pre-specified adverse event categories potentially causally related to one or both of the therapies because of their pharmacology were statistically analyzed. No significant differences were seen between treatment groups. Table 4 : Number of Patients with Pre-specified Adverse Reactions in Trials 0030 and 0027 Adverse Reaction* Number (n) and Percentage of Patients ARIMIDEX 1 mg (N=506) n (%) NOLVADEX 20 mg (N=511) n (%) Depression 23 (5) 32 (6) Tumor Flare 15 (3) 18 (4) Thromboembolic Disease’ 18 (4) 33 (6) Venous’ 5 15 Coronary and Cerebral’ 13 19 Gastrointestinal Disturbance 170 (34) 196 (38) Hot Flushes 134 (26) 118 (23) Vaginal Dryness 9 (2) 3 (1) Lethargy 6 (1) 15 (3) Vaginal Bleeding 5 (1) 11 (2) Weight Gain 11 (2) 8 (2) * A patient may have had more than 1 adverse reaction. ARIMIDEX was tolerated in two controlled clinical trials (i. The principal adverse reaction more common with ARIMIDEX than megestrol acetate was diarrhea. Adverse reactions reported in greater than 5% of the patients in any of the treatment groups in these two controlled clinical trials, regardless of causality, are presented below: Table 5 :Number (N) and Percentage of Patients with Adverse Reactions in Trials 0004 and 0005 Adverse Reaction* ARIMIDEX 1 mg (N=262) ARIMIDEX 10 mg (N=246) Megestrol Acetate 160 mg (N=253) n % n % n % Asthenia 42 (16) 33 (13) 47 (19) Nausea 41 (16) 48 (20) 28 (11) Headache 34 (13) 44 (18) 24 (9) Hot Flashes 32 (12) 29 (11) 21 (8) Pain 28 (11) 38 (15) 29 (11) Back Pain 28 (11) 26 (11) 19 (8) Dyspnea 24 (9) 27 (11) 53 (21) Vomiting 24 (9) 26 (11) 16 (6) Cough Increased 22 (8) 18 (7) 19 (8) Diarrhea 22 (8) 18 (7) 7 (3) Constipation 18 (7) 18 (7) 21 (8) Abdominal Pain 18 (7) 14 (6) 18 (7) Anorexia 18 (7) 19 (8) 11 (4) Bone Pain 17 (6) 26 (12) 19 (8) Pharyngitis 16 (6) 23 (9) 15 (6) Dizziness 16 (6) 12 (5) 15 (6) Rash 15 (6) 15 (6) 19 (8) Dry Mouth 15 (6) 11 (4) 13 (5) Peripheral Edema 14 (5) 21 (9) 28 (11) Pelvic Pain 14 (5) 17 (7) 13 (5) Depression 14 (5) 6 (2) 5 (2) Chest Pain 13 (5) 18 (7) 13 (5) Paresthesia 12 (5) 15 (6) 9 (4) Vaginal Hemorrhage 6 (2) 4 (2) 13 (5) Weight Gain 4 (2) 9 (4) 30 (12) Sweating 4 (2) 3 (1) 16 (6) Increased Appetite 0 (0) 1 (0) 13 (5) * A patient may have had more than one adverse reaction. Other less frequent (2% to 5%) adverse reactions reported in patients receiving ARIMIDEX l mg in either Trial 0004 or Trial 0005 are listed below. These adverse experiences are listed by body system and are in order of decreasing frequency within each body system regardless of assessed causality.
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