Among the reported cases in patients, the tumor stabilized or regressed on discontinuation of treatment.
The ANSM has observed cases of meningiomaa tumor often benign of the envelope of the brain, with new progestins. These hormonal treatments are prescribed as a last resort women suffering from endometriosis, menstrual cycle disorders or fibroids.
In a communiquéthe National Medicines Safety Agency establishes new recommendationswhich relate to progestins medrogestone (Colprone 5 mg), progesterone 100 or 200 mg (Utrogestan and generics), dydrogestérone (Duphaston 10 mg) et dienogest (generic Visanne 2 mg).
ANSM recommendations
Among the reported cases of meningioma in patients on progestin, the tumor has stabilized or shrunk when treatment is stopped with medrogestone (Colprone) and progesterone 100 mg and 200 mg (Utrogestan and generics). Clearly, this suggests that these drugs would have had a role in the appearance of the meningioma, but also that the possible impact is not irreversible.
Thus, to limit the risk of meningioma, the ANSM recommends:
- do not use other progestins in case of a history of meningioma or existing meningioma, except “exception to be assessed in a multidisciplinary consultation meeting” ;
- check all the progestins that have already been used as well as their duration of use, especially when it is a new progestogen”in relay of a previous treatment with cyproterone acetate, chlormadinone or nomegestrol does not exclude the risk of meningioma, without it being possible for the moment to determine it“.
- use the minimum dose of treatment with a very short duration;
- evaluate the interest in continuing the treatment every year;
- perform a brain MRI, especially in cases of symptoms suggestive of meningioma.
Epidemiological studies, carried out between 2019 and 2020, had already demonstrated that there was a “a risk of meningioma which increases with the dose received, for three progestins”, indicates the National Agency for the Safety of Medicines and Health Products (ANSM). It is Androcur (acetate of cyprotérone)Lutenyl acetate nomegestrol), Luteran (acetate of chlormadinone) and generics.
