{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,10]],"date-time":"2026-11-10T04:28:55Z","timestamp":1794284935837,"version":"4.9.0"},"reference-count":62,"publisher":"BMJ","license":[{"start":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T00:00:00Z","timestamp":1711497600000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ"],"accepted":{"date-parts":[[2024,2,22]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the risk of intracranial meningioma associated with the use of selected progestogens.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Design<\/jats:title>\n                    <jats:p>National case-control study.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Setting<\/jats:title>\n                    <jats:p>\n                      French National Health Data System (ie,\n                      <jats:italic>Syst\u00e8me National des Donn\u00e9es de Sant\u00e9<\/jats:italic>\n                      ).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Participants<\/jats:title>\n                    <jats:p>Of 108 366 women overall, 18\u2009061 women living in France who had intracranial surgery for meningioma between 1 January 2009 and 31 December 2018 (restricted inclusion periods for intrauterine systems) were deemed to be in the case group. Each case was matched to five controls for year of birth and area of residence (90\u2009305 controls).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Main outcome measures<\/jats:title>\n                    <jats:p>Selected progestogens were used: progesterone, hydroxyprogesterone, dydrogesterone, medrogestone, medroxyprogesterone acetate, promegestone, dienogest, and intrauterine levonorgestrel. For each progestogen, use was defined by at least one dispensation within the year before the index date (within three years for 13.5 mg levonorgestrel intrauterine systems and five years for 52 mg). Conditional logistic regression was used to calculate odds ratio for each progestogen meningioma association.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Mean age was 57.6 years (standard deviation 12.8). Analyses showed excess risk of meningioma with use of medrogestone (42 exposed cases\/18\u2009061 cases (0.2%)\n                      <jats:italic>v<\/jats:italic>\n                      79 exposed controls\/90\u2009305 controls (0.1%), odds ratio 3.49 (95% confidence interval 2.38 to 5.10)), medroxyprogesterone acetate (injectable, 9\/18\u2009061 (0.05%)\n                      <jats:italic>v<\/jats:italic>\n                      11\/90\u2009305 (0.01%), 5.55 (2.27 to 13.56)), and promegestone (83\/18\u2009061 (0.5%)\n                      <jats:italic>v<\/jats:italic>\n                      225\/90\u2009305 (0.2 %), 2.39 (1.85 to 3.09)). This excess risk was driven by prolonged use (\u2265one year). Results showed no excess risk of intracranial meningioma for progesterone, dydrogesterone, or levonorgestrel intrauterine systems. No conclusions could be drawn concerning dienogest or hydroxyprogesterone because of the small number of individuals who received these drugs. A highly increased risk of meningioma was observed for cyproterone acetate (891\/18\u2009061 (4.9%)\n                      <jats:italic>v<\/jats:italic>\n                      256\/90\u2009305 (0.3%), odds ratio 19.21 (95% confidence interval 16.61 to 22.22)), nomegestrol acetate (925\/18\u2009061 (5.1%)\n                      <jats:italic>v<\/jats:italic>\n                      1121\/90\u2009305 (1.2%), 4.93 (4.50 to 5.41)), and chlormadinone acetate (628\/18\u2009061 (3.5%)\n                      <jats:italic>v<\/jats:italic>\n                      946\/90\u2009305 (1.0%), 3.87 (3.48 to 4.30)), which were used as positive controls for use.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Prolonged use of medrogestone, medroxyprogesterone acetate, and promegestone was found to increase the risk of intracranial meningioma. The increased risk associated with the use of injectable medroxyprogesterone acetate, a widely used contraceptive, and the safety of levonorgestrel intrauterine systems are important new findings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1136\/bmj-2023-078078","type":"journal-article","created":{"date-parts":[[2024,3,27]],"date-time":"2024-03-27T20:07:55Z","timestamp":1711570075000},"page":"e078078","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":82,"title":["Use of progestogens and the risk of intracranial meningioma: national case-control study"],"prefix":"10.1136","volume":"384","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8079-4263","authenticated-orcid":false,"given":"No\u00e9mie","family":"Roland","sequence":"first","affiliation":[{"name":"EPI-PHARE Scientific Interest Group, French National Agency for Medicines and Health Products Safety, French National Health Insurance, Saint-Denis, 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