JNNP: Cyproterone Acetate and Meningioma Risk: A National Cohort Study

Cyproterone acetate (CPA) is related to the occurrence of meningioma in preliminary studies
.

Due to the properties of antiandrogens and gonadotropins, CPA may induce or increase the growth of meningiomas, because two-thirds of meningiomas express progesterone and androgen receptors

In this prospective registration-based cohort study, we used nationwide Danish registrations to identify all individuals born between 1930 and 2000
.

These individuals were included in the study at the age of 15, the date of emigration to Denmark, or January 1, 1995 (whichever is later)

The relationship between CPA and meningioma

Since January 1, 1995, the cumulative dose of CPA was summarized during the follow-up period, and subjects were divided into three exposure groups: no CPA, 0.
1-10 grams of CPA (obtained after the first prescription of CPA), and more than 10 grams CPA
.

In order to evaluate the time trend of drug use, the possible indications of CPA treatment were determined as (1) prostate disease, (2) feminizing hormone therapy or (3) other or unknown

730 635 subjects were included in the cohort, and 1982 (0.
035%) received CPA treatment during the follow-up period
.

The average follow-up time was 16.

Cumulative exposure to 0.
1-10 grams of CPA has 6 cases of meningiomas, the incidence rate is 78.
9 per 100,000 person-years, and the HR is adjusted to 7.
0 (95% CI 3.
1 to 15.
6), compared with non-users (Figure 1B )
.

Compared with people who did not use CPA, people with cumulative exposure to CPA>10g experienced 10 cases of meningioma, with an incidence rate of 187.

In the subgroup analysis stratified by sex at birth, there were three events in the female sex group at birth, and there was no significant increase in adjusted HR
.

In the subgroup of known prostate diseases, there were four events, and the adjusted HR also did not increase significantly

In summary, in this nationwide study, the cumulative dose of CPA was associated with the increased risk of meningioma and the use of CPA in the past
.

In summary, in this nationwide study, the cumulative dose of CPA was associated with the increased risk of meningioma and the use of CPA in the past
.

Mikkelsen  AP ,  Greiber  IK ,  Scheller  NM Mikkelsen  AP Mikkelsen Greiber  IK Greiber Scheller  NM Scheller , et al Cyproterone acetate and risk of meningioma: a nationwide cohort study Journal of Neurology, Neurosurgery & Psychiatry  Published Online First:  29 June 2021.
  Published Online First: doi:  10.
1136/jnnp-2021-326138 doi: leave a message here