In a new study from the University of Bristol, researchers found 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.
Meningioma is the most common type of benign brain tumor.
Typically slow-growing, meningiomas are benign tumors, which are often revealed incidentally by imaging but can cause big 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) are usually prescribed to men with inoperable prostate cancer, a condition that 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, the team did a review and meta-analysis study using four studies comprising a sample of 8,132,348 patients, to assess the link between the hormone drug and meningiomas.
The sample included 165,988 patients who were identified as taking cyproterone acetate at varying dose amounts.
The team says prescription of high-dose cyproterone acetate, especially for off-label indications, should be considered carefully.
Additionally, they 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.
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The study is published in Scientific Reports and was conducted by Keng Siang Lee et al.
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