Depot medroxyprogesterone acetate linked to increased meningioma risk

Women using depot medroxyprogesterone acetate are at heightened risk of subsequent meningioma diagnosis, although the overall clinical risk is low, according to a retrospective study.

Researchers used data from the TriNetX database and identified women who used a single, specific contraceptive method (depot medroxyprogesterone acetate, oral medroxyprogesterone acetate, combined oral contraceptives, intrauterine devices [IUDs], progestin only pills, or subdermal implantable contraceptive).

A total of 10,425,438 women (mean age 33.4 years) met the inclusion criteria. From these, a propensity-score matched cohort was established, comprising 88,667 participants (mean age 26.2 years) in the depot medroxyprogesterone acetate group and 86,064 in the IUD group (control).

Compared with IUD, the use of depot medroxyprogesterone acetate was associated with a more than twofold higher risk of subsequent meningioma diagnosis (relative risk [RR], 2.43, 95 percent confidence interval [CI], 1.77–3.33). This risk increase was evident only among participants who had longer than 4 years of exposure or who started the prescription at ages older than 31 years.

Oral medroxyprogesterone acetate was also associated with a risk increase (RR, 1.18, 95 percent CI, 1.10–1.27) compared with IUD. No other contraceptives influenced the risk of meningioma diagnosis.

The number needed to harm was high at 1,152 patients for the depot medroxyprogesterone acetate and 3,020 patients for oral medroxyprogesterone acetate.