Widely-used hormone drug associated with increased risk of benign brain
tumor at high doses

Date:
February 4, 2022
Source:
University of Bristol
Summary:
High doses of a widely-used drug used in the hormonal treatment
of conditions such as excessive hair growth, early puberty,
prostate cancer, are linked to an increased risk of meningioma --
the most common type of benign brain tumor, finds a new study of
over 8-million patients.



FULL STORY ==========================================================================
High doses of a widely-used drug used in the hormonal treatment of
conditions such as excessive hair growth, early puberty, prostate cancer,
are linked to an increased risk of meningioma -- the most common type
of benign brain tumour, finds a University of Bristol-led study of over 8-million patients. The study is published in Scientific Reportstoday
[Friday 4 Feb 2022].


========================================================================== Typically slow-growing, meningiomas are benign tumours, which are often revealed incidentally by imaging but can cause significant disability
due to compressing or squeezing the adjacent brain, nerves and vessels
and pressure effects within a fixed cranial vault.

Recent studies have reported an association between the growth of
meningiomas and hormonal treatments, particularly prolonged and high
dose use of the drug cyproterone acetate (CPA).

High doses of cyproterone acetate (> 50 mg/day) is usually prescribed
to male patients with inoperable prostate cancer, a condition which
leads to excessive hair growth known as hirsutism, or male-to-female transsexual hormonal therapy.

Lower doses (2-10 mg/day) of the drug are typically used in combination
with oestradiol to treat androgen-associated alopecia or female
seborrhoea.

Given the drug's widespread use, researchers at the Universities of
Bristol, Cambridge and the National University of Singapore, conducted a systematic review and meta-analysis study using four studies comprising
a sample of 8,132,348 patients, to assess the evidence of the association between cyproterone acetate and incidence of meningiomas.

The sample included 165,988 patients who were identified as taking
cyproterone acetate at varying dose amounts. Using this data, the team
analysed the occurrence of meningioma in patients using high versus low
dose cyproterone acetate and found a significant association between high
dose usage and increased risk of meningioma. However, this association
was not found with low doses.

Keng Siang Lee, a medical student and the study's lead author from
Bristol Medical School at the University of Bristol, said: "The cause of meningiomas is controversial but there is strong evidence to suggest a plausible role for sex hormones in the onset of meningioma. We know it
has a predilection for females especially after puberty. Furthermore, fluctuations in meningioma growth during the menstrual cycle, pregnancy,
and breastfeeding have also been well- documented. We are also aware
of the well-characterised distribution of progesterone, oestrogen,
and androgen receptors in certain meningiomas located at the base of
the skull.

"In light of these results, prescription of high-dose cyproterone acetate, especially for off label indications, should be considered carefully.

Additionally, we suggest that routine screening and meningioma
surveillance by brain MRI offered to patients prescribed with cyproterone acetate is likely a reasonable clinical consideration if given at high
doses for long periods of time.

"However, our study underscores the current limited evidence
about the risk of intracranial meningioma associated with low
dose cyproterone acetate. It is still unknown whether or not
cyproterone acetate below a certain threshold may be completely
safe in terms of the risk of meningioma. The results obtained
herein suggest the necessity for further clinical research
on intracranial meningioma associated with cyproterone acetate." ========================================================================== Story Source: Materials provided by University_of_Bristol. Note: Content
may be edited for style and length.


========================================================================== Journal Reference:
1. Keng Siang Lee, John J. Y. Zhang, Ramez Kirollos, Thomas Santarius,
Vincent Diong Weng Nga, Tseng Tsai Yeo. A systematic review and
meta- analysis of the association between cyproterone acetate and
intracranial meningiomas. Scientific Reports, 2022; 12 (1) DOI:
10.1038/s41598-022- 05773-z ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2022/02/220204113440.htm

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