Use of high dose cyproterone acetate and risk of intracranial meningioma in women: cohort study

The study analyzed the risk of intracranial meningioma in 253,777 women aged 7-70 who used high-dose cyproterone acetate in France from 2007 to 2014. It compared 139,222 participants who received a cumulative dose of at least 3 g (exposed group) to 114,555 who received less than 3 g (control group). The study found a significantly higher incidence of meningioma in the exposed group (23.8 per 100,000 person-years) compared to the control group (4.5 per 100,000 person-years), with an adjusted hazard ratio of 21.7 for doses over 60 g. The risk remained 1.8 times higher in the exposed group even after discontinuing the drug for a year. Meningiomas were specifically located in the anterior and middle skull base and were also observed in a subgroup of 10,876 transgender participants. The study concluded that there is a strong dose-effect relationship between cyproterone acetate use and the risk of intracranial meningiomas, which decreases after stopping the treatment.