Cyproterone acetate is a synthetic progestogen with potent antiandrogen properties. While the drug has been approved, excessive usage has been linked with instances of intracranial meningioma. This study aims to evaluate the risk of meningioma in women associated with a high dose of cyproterone acetate.

This observational cohort study included a total of 253,777 females aged 7-70 years. The included participants had at least one reimbursement for high dose cyproterone acetate and no history of meningioma or other benign brain tumors. They were classified into two groups: exposed (had at least 3g of cumulative dose during the first six months) and slightly exposed (less than 3g). The primary outcome of the study was radiotherapy or resection/decompression surgery for one or more intracranial meningiomas.

The findings suggested that a total of 69 meningiomas in the exposed group and 20 meningiomas in the slightly exposed group underwent radiotherapy or surgery. The incidence of meningioma in the groups was 23.8 per 100,000 person-years and 4.5 per 100,000 person-years, respectively. The adjusted hazard ratio for dose-related risk for more than 60g of the dose was 21.7.

The research concluded that there was a strong dose-effect relation between the use of cyproterone acetate and the risk of intracranial meningiomas.

Ref: https://www.bmj.com/content/372/bmj.n37