2023-06-26 16:30:33
Androcur, Lutényl, Lutéran: these treatments, prescribed to many women, have proven to promote the appearance of brain tumours. But what regarding other drugs in this category, progestins? The risk exists for some but not for all, finally shows a large study.
“Prolonged use of promegestone (Surgestone 0.5 mg), medrogestone (Colprone 5 mg), or medroxyprogesterone acetate (Depo Provera 150 mg/3 ml) is associated with an increased risk of meningioma,” announced Monday. the French drug agency, ANSM.
All three drugs are progestins. Essentially intended for women, this category of treatments aims to treat a wide range of problems: female pathologies such as endometriosis, infertility, support for menopause… They are sometimes also used as contraception.
However, since the 2010s, certain progestins have been shown to promote the appearance of meningiomas. These brain tumors are sometimes referred to as “benign” because they are not likely to develop into fatal cancers, but they can cause serious neurological disabilities.
It was first the drug Androcur (cyproterone acetate) which was implicated. Theoretically indicated once morest excessive hair, but prescribed for decades by many doctors well beyond these indications – for example once morest endometriosis – its link with meningiomas was clearly established in 2018.
Two other treatments followed the same path: Luteran (chlormadinone) and Lutényl (nomestrol). For these three drugs, which have not however been banned given their interest in certain specific indications, prescriptions have fallen.
But “obviously, we feared for a certain number of other progestins”, explained to AFP the researcher and doctor Alain Weill, who supervised for the ANSM and the Health Insurance a large retrospective study on a hundred thousand of patients.
reassuring elements
Conclusion of this study: Colprone, Surgestone and Depo Provera increase the risk of meningioma well, respectively by 4.1, 2.7 and 5.6, when taken for more than a year. The risk increases gradually with the duration of treatment.
Collectively, it is above all Colprone that poses a problem. Surgestone has not been marketed for two years and Depo Provera is very little given.
In contrast, Colprone is currently prescribed to tens of thousands of women. And it is more and more so, because it serves as an alternative to patients who have precisely abandoned Androcur, Lutényl or Lutéran because of the risk of meningioma.
Still, in several respects, the study is also reassuring. Some treatments, such as Utrogestan (progesterone) and Duphaston and Climaston (dydrogesterone), do not present any risks even though they are prescribed to hundreds of thousands of patients.
Above all, there is no risk associated with the use of an IUD delivering progestins. A device probably used by more than 500,000 women in France, according to the researchers.
A doubt, finally, remains on a treatment, the dienogest. It was not prescribed enough during the years studied (2009-2018) to draw statistically reliable conclusions, but it has been given much more since the 2020s.
“There is always uncertainty hanging over this drug when it is presented by gynecologists as a miracle treatment”, in particular for endometriosis, regretted to AFP Emmanuelle Mignaton, president of the Amavea association, which includes patients with meningiomas following taking progestins.
But, on the whole, the relief dominates for Ms. Mignaton who, like many patients, criticizes the health authorities for having delayed too long a few years ago in the face of the first alerts on Androcur.
“There, really, the agency (of the drug) takes things in hand in a way that seems good to me, rigorous and fast”, she estimated.
“It is a relief that the situation is becoming more and more clear, to see which drugs are a risk and which are not”, concluded Emmanuelle Mignaton.
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