Meningiomas: 3 new progestins increase the risk

Already associated with certain progestins such as Androcur, Lutényl or Lutéran, a risk of meningioma does exist with three new substances, but not with hormonal IUDs.

Progestins and meningiomas

As part of the reinforced monitoring of all progestins, a new pharmacoepidemiology study has made it possible to assess the risk of meningioma associated with this class of drugs. Progestins are medications used in gynecological pathologies (endometriosis, fibroids, particularly long and/or heavy periods, cycle disorders), in hormone replacement therapy (including menopause); but also in obstetrics (sterility due to luteal insufficiency, repeated abortions). They are therefore regularly prescribed in a woman’s journey.

Three new progestins linked to risks of meningiomas

Based on data from the National Health Data System (SNDS), EPI-PHARE (the scientific interest group in epidemiology of health products created by the National Medicines Safety Agency (ANSM) and health insurance Editor’s note ), conducted a study aimed at evaluating the risk of operated intracranial meningioma in women linked to the use of progestins (progesterone, medrogestone, medroxyprogesterone, dydrogesterone, promegestone, dienogest). The risk of meningioma linked to levonorgestrel intrauterine devices, also called hormonal IUDs, has also been studied.

This study carried out on more than 18,000 women operated on for meningioma and more than 90,000 “control” women between 2009 and 2018 shows that the prolonged use of:

is associated with an increased risk of meningioma.

This excess risk is multiplied by 2.5 for promegestone, 4.1 for medrogestone, and 5.6 with medroxyprogesterone acetate.

“This is increased when the duration of use of these drugs at the dosage authorized by the marketing authorization exceeds 1 year, as is the case with chlormadinone acetates (Luteran and generics), nomegestrol (Lutenyl and generics) and cyproterone (Androcur and generics)” specifies the press release.

Levonorgestrel IUD and progesterone do not increase risks

Conversely, the results with levonorgestrel 13.5 and 52 mg IUDs, widely used contraceptives, do not show an increased risk of meningioma. Likewise, exposure to progesterone (oral, intravaginal and cutaneous) (Utrogestan and generics) and dydrogesterone (Duphaston, Climaston) was not significantly associated with an increased risk of intracranial meningioma surgery. Additional studies on dienogest (Visanne and generics), reimbursed since 2020, should be considered.