| Sumario: | Simple Summary: Research has reported an increased association between injected medroxyprogesterone acetate—a synthetic progesterone used for contraception—and cerebral meningioma, a type of tumor that affects the meninges, which are the covering layers of the brain. To build upon the prior literature, the current study compared medroxyprogesterone acetate exposure to two comparator groups: an active contraceptive comparator (i.e., levonorgestrel and norethindrone) and non-active comparator. Medroxyprogesterone acetate exposure was associated with increased odds of cerebral meningioma for exposure within the prior year compared to both the active and non-active comparator group and for two years prior compared to non-active comparator exposure. The current study supports the prior findings of an increased association between cerebral meningioma and injected medroxyprogesterone acetate exposure; this study adds to the literature that the association persists when compared to an active comparator. Clinicians may want to consider discussing with patients the increased association between injection medroxyprogesterone acetate and cerebral meningioma. The recent literature has reported an increased association between the use of depot medroxyprogesterone acetate (dMPA) and cerebral meningioma (CM). Prior studies have been limited in generalizability and did not use an active comparator as a control. The current matched case–control study utilized a bootstrapped sampling design, matching 241 CM cases with controls (i.e., women diagnosed with non-meningioma brain, breast, or skin tumor, one control per type for three total) on age ± 5 years and diagnosis date ± 3 months. Conditional logistic regression was used to estimate odds ratios (ORs) compared with an active (norethindrone or levonorgestrel) and non-active control group. Exposure to dMPA at any time point was not associated with the diagnosis of cerebral meningioma (OR 1.75, 95% CI 0.81–4.95). Exposure to dMPA within a year of diagnosis was associated with the diagnosis of CM compared to both an active control (OR 3.38, 95% CI 1.13–9.70) and a non-active control (OR 6.90, 95% CI 2.31–17.58). This association was also present for those who were exposed within two years prior when compared to a non-active control (OR 3.54, 95% CI 1.50–11.88) but not an active control. Combined with the prior literature, the current results suggest that future research is warranted to understand this association.
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