Evaluation of the Efficacy and Acceptability of a Phytotherapy Combining Devil's Claw, Blackcurrant and Meadowsweet for the Management of Aromatase Inhibitor-induced Arthralgia in Patients Treated for Localized Breast Cancer in the Adjuvant Setting (ERABLE)
Adjuvant hormonotherapy is a cornerstone of treatment for localized hormone receptor-positive (HR+) breast cancer, accounting for approximately 80% of patients. The main classes used are selective estrogen receptor modulators (SERMs, including tamoxifen) and aromatase inhibitors (anastrozole, letrozole, exemestane), with or without LH-RH agonists (leuprorelin, goserelin), administered daily for 5 to 8 years.
However, these treatments are frequently associated with adverse events, predominantly musculoskeletal disorders such as arthralgia, which can significantly impair quality of life. These symptoms cause functional impact and promote premature discontinuation of treatment, thereby compromising therapeutic adherence and increasing the risk of tumor relapse.
Current management strategies for these arthralgias, whether pharmacological or non-pharmacological, show limited efficacy or insufficient levels of evidence, with the exception of certain approaches like acupuncture. In the absence of satisfactory solutions, many patients turn to alternative medicines, notably phytotherapy. However, these practices raise safety concerns (drug interactions, misuse) and rely on limited scientific evidence, especially since they are often underreported to healthcare professionals.
In this context, there is a clear need to rigorously evaluate new therapeutic approaches. The non-randomized ERABLE study aims to explore the efficacy and acceptability of a phytotherapy selected for its analgesic properties on hormone therapy-induced arthralgia in patients treated for localized breast cancer. If positive, this study will be followed by a randomized trial to confirm efficacy and achieve a level of evidence compatible with clinical guidelines.
Descripción general del estudio
Estado
Condiciones
Tipo de estudio
Inscripción (Estimado)
Fase
- Fase 4
Contactos y Ubicaciones
Estudio Contacto
- Nombre: Gilles FREYER, Pr
- Número de teléfono: +33 04 78 86 43 18
- Correo electrónico: gilles.freyer@chu-lyon.fr
Copia de seguridad de contactos de estudio
- Nombre: Angelique STUANI
- Número de teléfono: +33 04 78 86 23 76
- Correo electrónico: angelique.stuani@chu-lyon.fr
Ubicaciones de estudio
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Bron, Francia
- Oncology Unit, Hospices Civils de Lyon Est
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Contacto:
- Marie BEGUINOT, PU, MD
- Número de teléfono: +33 04 72 35 58 85
- Correo electrónico: marie.beguinot@chu-lyon.fr
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Investigador principal:
- Marie BEGUINOT, PU, MD
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Lyon, Francia
- Oncology Unit, Hospices Civils de Lyon Nord
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Contacto:
- Eva KALFALA, PU, MD
- Número de teléfono: +33 04 26 73 26 12
- Correo electrónico: Eva.kalfala@chu-lyon.fr
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Investigador principal:
- Eva KALFALA, PU, MD
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Pierre-Bénite, Francia
- Oncology Unit, Hospices Civils de Lyon Sud
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Contacto:
- Gilles FREYER, PU-PH
- Número de teléfono: +33 04 78 86 43 18
- Correo electrónico: gilles.freyer@chu-lyon.fr
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Investigador principal:
- Gilles FREYER, PU-PH
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Criterios de participación
Criterio de elegibilidad
Edades elegibles para estudiar
Acepta Voluntarios Saludables
Géneros elegibles para el estudio
Descripción
Inclusion Criteria:
• Common Inclusion Criteria (applicable to both cohorts):
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Age 18 years or older.
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Histologically or clinically confirmed localized breast cancer treated for at least 3 months with adjuvant hormone therapy according to standard clinical practices: selective estrogen receptor modulators (SERMs, e.g., tamoxifen alone), aromatase inhibitors (AIs, e.g., anastrozole, letrozole, or exemestane alone), or in combination with an LH-RH agonist (goserelin or leuprorelin). Concomitant targeted therapy with ribociclib or abemaciclib is permitted.
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Suffering from hormone therapy-induced arthralgia with a severity score of $\ge 4/10$ on a numerical rating scale (NRS).
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For women of childbearing potential: use of a highly effective contraception method throughout the study duration (excluding hormonal options, prioritizing mechanical methods such as a copper intrauterine device, male/female condoms, surgical methods like bilateral tubal ligation, or true abstinence).
• Specific Inclusion Criteria for the Interventional Cohort:
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Provided signed and dated written informed consent.
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Affiliated with or a beneficiary of a social security regime.
• Specific Selection Criteria for the External Control Group:
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Availability of necessary clinical data required for the primary outcome evaluation (joint pain assessment at baseline/Day 0 and Day 21 $\pm 3$ days).
Exclusion Criteria:
• Specific Exclusion Criteria for the Interventional Cohort:
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Presence of medical conditions contraindicating the active ingredients of the dietary supplement: active gastroduodenal ulcer, biliary disorders (gallstones), uncontrolled heart failure, or edematous renal failure.
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Known allergy or hypersensitivity to any of the components of the dietary supplement (blackcurrant, meadowsweet, excipients, etc.).
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Hypersensitivity to salicylates.
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Pregnant or breastfeeding women.
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Persons deprived of liberty or under legal guardianship/protection.
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Inability to complete the study diary during the follow-up period based on the investigator's judgment (e.g., non-French speaking/allophone, dementia).
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Impossibility to comply with the medical follow-up of the study for geographical, social, or psychological reasons.
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Concurrent participation in another clinical, drug, or cosmetic research study.
• Specific Non-Selection Criteria for the External Control Group:
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Patient objection or refusal regarding the reuse of their medical data for research purposes.
Plan de estudios
¿Cómo está diseñado el estudio?
Detalles de diseño
- Propósito principal: Cuidados de apoyo
- Asignación: No aleatorizado
- Modelo Intervencionista: Asignación paralela
- Enmascaramiento: Ninguno (etiqueta abierta)
Armas e Intervenciones
Grupo de participantes/brazo |
Intervención / Tratamiento |
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Experimental: Herbal dietary supplement group (interventional group)
Patients in the interventional arm receive a daily oral herbal dietary supplement combining Devil's claw (Harpagophytum procumbens), Meadowsweet (Filipendula ulmaria), and Blackcurrant (Ribes nigrum). The intervention is administered in a capsule dosage form at a dose of 2 capsules twice daily (totaling 4 capsules per day) for a duration of 21 consecutive days. This supportive care treatment is taken concomitantly with the patient's ongoing, standard adjuvant hormone therapy (tamoxifen, aromatase inhibitors, or LH-RH analogues) to evaluate its efficacy in managing hormone therapy-induced arthralgia. |
Suplemento dietético: Phytotherapy Dietary Supplement (Harpagophytum, Meadowsweet, and Blackcurrant)
Administration of an oral herbal dietary supplement combining Devil's claw (Harpagophytum procumbens), Meadowsweet (Filipendula ulmaria), and Blackcurrant (Ribes nigrum). The product is provided in capsule dosage form at a dose of 2 capsules twice daily (4 capsules per day) for a duration of 21 consecutive days, taken concomitantly with the patient's ongoing adjuvant hormone therapy to manage joint pain. Administration of an ad hoc questionnaire utilizing Likert scales, conducted via telephone interview at Day 21. This tool evaluates the patient's feedback on three key implementation dimensions based on Proctor's framework: acceptability (overall perception, perceived satisfaction, and encountered difficulties), appropriateness (perceived relevance and suitability of the intervention), and feasibility. |
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Sin intervención: Standard of care (External control)
Patients in the external control group receive standard of care management for their hormone therapy-induced arthralgia, with no experimental phytotherapeutic intervention administered. Data regarding their joint pain are collected from routine clinical practice medical records, including a baseline numerical pain rating scale assessment (Day 0) and a follow-up assessment conducted by telephone at Day 21 (+ 3 days) during routine oncology follow-up. This group is matched with the interventional cohort based on clinical criteria such as age, hormone therapy type, and treatment line. |
¿Qué mide el estudio?
Medidas de resultado primarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change in joint pain score from baseline to day 21
Periodo de tiempo: Baseline (Day 0) and Day 21 (+ 3 days)
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Joint pain intensity is self-reported by the patient using an 11-point Numerical Rating Scale (NRS), where 0 represents "no pain" and 10 represents "worst imaginable pain." The primary outcome is calculated as the change in the NRS score from baseline (Day 0) to Day 21, comparing the interventional group with the matched external control group. |
Baseline (Day 0) and Day 21 (+ 3 days)
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Medidas de resultado secundarias
Medida de resultado |
Medida Descripción |
Periodo de tiempo |
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Change in analgesic medication consumption
Periodo de tiempo: Daily tracking during the first week (Day 0 to Day 7) and final week (Day 14 to Day 21) of the 21-day intervention period
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Patient self-reported consumption of analgesic treatments (paracetamol, non-steroidal anti-inflammatory drugs, tramadol, codeine-containing paracetamol, morphine sulfate, or oxycodone) recorded prospectively via a daily tracking diary during the first week (Day 0 to Day 7) and the final week (Day 14 to Day 21) of the study period. |
Daily tracking during the first week (Day 0 to Day 7) and final week (Day 14 to Day 21) of the 21-day intervention period
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Incidence and severity of adverse events (Tolerance)
Periodo de tiempo: Throughout the intervention and follow-up period, from Day 0 up to Day 28 (+ 3 days)
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Assessment of adverse events and treatment safety evaluated through patient reporting in the study diary and clinical monitoring throughout the intervention period. Toxicity is graded according to the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI CTCAE v6.0). |
Throughout the intervention and follow-up period, from Day 0 up to Day 28 (+ 3 days)
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Patient experience assessment: acceptability, appropriateness, and feasibility
Periodo de tiempo: Day 21 (+ 3 days) via telephone interview
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Evaluation of the patient's feedback regarding the phytotherapy dietary supplement using an ad hoc questionnaire with Likert scales based on Proctor's implementation framework. The questionnaire assesses three core dimensions: acceptability (overall perception, satisfaction, and difficulties encountered), appropriateness (perceived relevance and suitability of the intervention), and feasibility. |
Day 21 (+ 3 days) via telephone interview
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Colaboradores e Investigadores
Patrocinador
Colaboradores
Investigadores
- Investigador principal: Gilles FREYER, Pr, Hospices Civils de Lyon
Fechas de registro del estudio
Fechas importantes del estudio
Inicio del estudio (Estimado)
Finalización primaria (Estimado)
Finalización del estudio (Estimado)
Fechas de registro del estudio
Enviado por primera vez
Primero enviado que cumplió con los criterios de control de calidad
Publicado por primera vez (Actual)
Actualizaciones de registros de estudio
Última actualización publicada (Actual)
Última actualización enviada que cumplió con los criterios de control de calidad
Última verificación
Más información
Términos relacionados con este estudio
Palabras clave
Términos MeSH relevantes adicionales
- Dolor
- Manifestaciones neurológicas
- Enfermedades musculoesqueléticas
- Neoplasias por sitio
- Neoplasias
- Enfermedades Articulares
- Enfermedades de la piel
- Enfermedades de los senos
- Condiciones Patológicas, Signos y Síntomas
- Enfermedades de la piel y del tejido conectivo
- Signos y síntomas
- Neoplasias de mama
- Artralgia
Otros números de identificación del estudio
- 69HCL26_0268
- 2026-A02232-49 (Otro identificador: ID-RCB)
Información sobre medicamentos y dispositivos, documentos del estudio
Estudia un producto farmacéutico regulado por la FDA de EE. UU.
Estudia un producto de dispositivo regulado por la FDA de EE. UU.
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