BMJ: High doses of cycloprogesterone acetate lead to a significant increase in the risk of meningoma

Cycloprogesterone acetate, a drug used to treat prostate cancer in men and severe androgenization in women, was introduced in many European countries in the 1970s, and since 2007 several cases of meningioma caused by the long-term (5-30 years) use of cycloprogesterone acetate have been reported, with doses of up to 25-100 mg per day.
recently looked at the correlation between high doses of cycloprogesterone acetate and meningoma risk.
The study, an observational cohort study, looked at data from the French SNDS database for 2007-17, which included data on 253,777 female participants aged 7-70 who began using cycloprogesterone acetate between 2007 and 2014, with no history of meningoma or benign encephalopathy on the baseline.
139,222 participants received at least 3g of cycloprogesterone acetate over a six-month month, identified as acetate cycloprogesterone exposure, and 114,555 participants received a cumulative dose of less than 3g, which was considered to be mildly exposed (control group).
end of the study was meningioma surgery or radiotherapy.
in 289,544 participants, the exposure group reported 69 cases of meningoma, while the control group reported 20 cases of meningoma in 439,949 participants.
incidence of meningomas in the two groups was 23.8 per 100,000 and 4.5 per 100,000 years, respectively (relative risk 5.2; correction risk ratio 6.6).
the cumulative dose of cycloprogesterone acetate was greater than 60g, the correction risk ratio was 21.7.
even after one year of deactivation of cycloprogesterone acetate, the exposure group was 1.8 times more likely to develop meninges than the control group.
acetaminophen-related meningiomas are located in the front and middle cranial floors, especially the inner part of the central cranial base accounted for one-third, affecting the butterfly area.
analysis of the male transgender subgroup found a high risk of meningoma (3 per 14,460 participants and 20.7 follow-up years per 100,000 participants).
found a significant increase in the risk of intracranial meningioma in people who had long-term heavy use of cycloprogesterone acetate.