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Exemestane and letrozole are third-generation aromatase inhibitors primarily used in the treatment of hormone receptor-positive breast cancer in postmenopausal women. Exemestane is a steroidal, irreversible (Type I) aromatase inactivator, while letrozole is a non-steroidal, reversible (Type II) aromatase inhibitor. In the context of the Data Analysis for Drug Repurposing for Effective Alzheimer's Medicines (DREAM) study led by Brigham and Women's Hospital, these two agents are grouped together as a reference cohort to evaluate the comparative risk of Alzheimer's disease and dementia onset. The research investigates whether the inhibition of estrogen synthesis via the aromatase pathway, or specific differences between these agents and anastrozole, correlates with a modified risk of neurodegenerative disease.
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