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A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas
The influence of exposure to hormonal treatments, particularly cyproterone acetate (CPA), has been posited to contribute to the growth of meningiomas. Given the widespread use of CPA, this systematic review and meta-analysis attempted to assess real-world evidence of the association between CPA and...
Autores principales: | , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
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Nature Publishing Group UK
2022
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8816922/ https://www.ncbi.nlm.nih.gov/pubmed/35121790 http://dx.doi.org/10.1038/s41598-022-05773-z |
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author | Lee, Keng Siang Zhang, John J. Y. Kirollos, Ramez Santarius, Thomas Nga, Vincent Diong Weng Yeo, Tseng Tsai |
author_facet | Lee, Keng Siang Zhang, John J. Y. Kirollos, Ramez Santarius, Thomas Nga, Vincent Diong Weng Yeo, Tseng Tsai |
author_sort | Lee, Keng Siang |
collection | PubMed |
description | The influence of exposure to hormonal treatments, particularly cyproterone acetate (CPA), has been posited to contribute to the growth of meningiomas. Given the widespread use of CPA, this systematic review and meta-analysis attempted to assess real-world evidence of the association between CPA and the occurrence of intracranial meningiomas. Systematic searches of Ovid MEDLINE, Embase and Cochrane Controlled Register of Controlled Trials, were performed from database inception to 18th December 2021. 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. When high and low dose patients were grouped together, there was no statistically significant increase in risk of meningioma associated with use of CPA (RR = 3.78 [95% CI 0.31–46.39], p = 0.190). Usage of CPA is associated with increased risk of meningioma at high doses but not when low doses are also included. 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. Our findings highlight the need for further research on this topic. |
format | Online Article Text |
id | pubmed-8816922 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2022 |
publisher | Nature Publishing Group UK |
record_format | MEDLINE/PubMed |
spelling | pubmed-88169222022-02-07 A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas Lee, Keng Siang Zhang, John J. Y. Kirollos, Ramez Santarius, Thomas Nga, Vincent Diong Weng Yeo, Tseng Tsai Sci Rep Article The influence of exposure to hormonal treatments, particularly cyproterone acetate (CPA), has been posited to contribute to the growth of meningiomas. Given the widespread use of CPA, this systematic review and meta-analysis attempted to assess real-world evidence of the association between CPA and the occurrence of intracranial meningiomas. Systematic searches of Ovid MEDLINE, Embase and Cochrane Controlled Register of Controlled Trials, were performed from database inception to 18th December 2021. 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. When high and low dose patients were grouped together, there was no statistically significant increase in risk of meningioma associated with use of CPA (RR = 3.78 [95% CI 0.31–46.39], p = 0.190). Usage of CPA is associated with increased risk of meningioma at high doses but not when low doses are also included. 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. Our findings highlight the need for further research on this topic. Nature Publishing Group UK 2022-02-04 /pmc/articles/PMC8816922/ /pubmed/35121790 http://dx.doi.org/10.1038/s41598-022-05773-z Text en © The Author(s) 2022 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . |
spellingShingle | Article Lee, Keng Siang Zhang, John J. Y. Kirollos, Ramez Santarius, Thomas Nga, Vincent Diong Weng Yeo, Tseng Tsai A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas |
title | A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas |
title_full | A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas |
title_fullStr | A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas |
title_full_unstemmed | A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas |
title_short | A systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas |
title_sort | systematic review and meta-analysis of the association between cyproterone acetate and intracranial meningiomas |
topic | Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8816922/ https://www.ncbi.nlm.nih.gov/pubmed/35121790 http://dx.doi.org/10.1038/s41598-022-05773-z |
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