DRUG ALERT! Study Confirms That Cyproterone Acetate Widely Used In Birth Control Pills Like Diane 35 Increases Risk Of Benign Brain Tumor!

A new study by researchers from University of Bristol-UK, National University of Singapore, University of Cambridge and Addenbrooke’s Hospital-UK and the National University Hospital-Singapore has alarmingly found that the hormone drug Cyproterone Acetate increases the risk developing benign brain tumors or meningiomas especially if used for long periods of time or in high doses.



Cyproterone acetate, a synthetic progestogen with anti-androgen effects approved in most countries and available commonly as an OTC drug.

Cyproterone acetate (CPA) is often sold alone under the brand name Androcur or with ethinylestradiol under the brand names Diane or Diane-35 among others. It is an antiandrogen and progestin medication used in the treatment of androgen-dependent conditions such as acne, excessive hair growth, early puberty, and prostate cancer, as a component of feminizing hormone therapy for transgender women, and in birth control pills. It is formulated and used both alone and in combination with an estrogen. Typically for the various therapeutic uses mentioned, CPA is taken by mouth one to three times per day which already constitutes a high dose.
 
To date there is growing evidence that the exposure to hormonal treatments, particularly cyproterone acetate (CPA), has been posited to contribute to the growth of meningiomas.
 
A meningioma is a primary central nervous system (CNS) tumor. This means it begins in the brain or spinal cord. Overall, meningiomas are the most common type of primary brain tumor.
 
Considering the widespread use of CPA, the study team decided to conduct a systematic review and meta-analysis attempted to assess real-world evidence of the association between CPA and the occurrence of intracranial meningiomas.
 
The systematic searches of Ovid MEDLINE, Embase and Cochrane Controlled Register of Controlled Trials, were performed from database inception to 18th December 2021.
 
A total of four retrospective observational studies reporting 8,132,348 patients were included in the meta-analysis. There was a total of 165,988 subjects with usage of CPA. The age of patients at meningioma diagnosis was generally above 45 years in all studies. The dosage of CPA taken by the exposed group (n = 165,988) was specified in three of the four included studies. All studies that analyzed high versus low dose CPA found a significant association between high dose CPA usage and increased risk of meningioma.
 
The study findings showed that the usage of CPA is associated with increased risk of meningioma at high doses. Routine screening and meningioma surveillance by brain MRI offered to patients prescribed with CPA is likely a reasonable clinical consideration if given at high doses for long periods of time.
 
The study findings were published in the peer reviewed journal: Science Reports. https://www.nature.com/articles/s41598-022-05773-z
 
The study findings from the research that covered more than 8-million patients is worrisome as cyproterone acetate is widely used in high doses in the hormonal treatment of conditions such as excessive hair growth, early puberty, prostate cancer. Worse many females are using it as bi rth control pills and many gay and even straight men and transgenders are using it to achieve so called better ‘skin complexions’ or for ‘feminizing purposes!’
 
Slow-growing, meningiomas are benign tumors, 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.
 
A few past 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).
 
Typically, 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.
 
The lower doses (2-10 mg/day) of the drug are typically used in combination with oestradiol to treat androgen-associated alopecia or female seborrhea and acne conditions.
 
Considering the drug's widespread use, the study team 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.
 
Utilizing this data, the study team analyzed 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.
 
The study's lead author Keng Siang Lee, a medical student and 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-characterized distribution of progesterone, estrogen, and androgen receptors in certain meningiomas located at the base of the skull."
 
He added, "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."
 
The study team warned, "However, our study findings 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."
 
Thailand Medical News strongly advices all those currently using cyproterone acetate in whatever forms to consult their physicians to look for alternative safer drugs and also to conduct relevant health screenings.
 
For more about cyproterone acetate and brain tumors keep on logging to Thailand Medical News.