Background/Objectives: Medroxyprogesterone acetate (MPA) is a synthetic progesterone that is most commonly used as a contraceptive. MPA acts by binding to the progesterone receptor of the hypothalamus, and this receptor has been found to be important in the pathophysiology of meningiomas. Recent research has reported an increased association between the use of MPA and intracranial meningioma, though the literature is mostly limited by low numbers of meningioma cases and low exposure to MPA. The objective of the current study is to build upon the previously published literature utilizing a large database from the United States. Methods: Utilizing a large commercial insurance database, the current matched case–control study identified meningioma cases using ICD-10 codes from hospital data and MPA exposure, as established from pharmaceutical claims data. Controls were matched 10:1 to cases based on age, year of enrollment, and duration of enrollment. A conditional logistic regression estimated odds ratios (ORs) for the association between MPA exposure and the odds of developing a meningioma. Results: Among 117,503 meningioma cases and 1,072,907 matched controls, oral MPA exposure was not associated with odds of meningioma; however, injection MPA exposure was associated with a 53% increased odds of being a case (OR 1.53, 95% CI 1.40–1.67). This association was specific to cerebral meningiomas (OR 1.68, 95% CI 1.50–1.87), an association that became stronger with a longer duration of use of injection MPA. Conclusions: The current results are consistent with the prior literature, which reports an association between injection exposures to MPA and a stronger association with increasing use of MPA. Women should be cautioned about the prolonged use of MPA, and future research should examine whether the extended use of MPA is associated with the meningioma grade.
背景/目的：醋酸甲羟孕酮（MPA）是一种合成孕激素，最常用作避孕药。MPA通过与下丘脑的孕激素受体结合发挥作用，而该受体已被发现在脑膜瘤的病理生理学中具有重要作用。近期研究报道了MPA使用与颅内脑膜瘤之间的关联性增强，但现有文献大多受限于脑膜瘤病例数量较少及MPA暴露水平较低。本研究旨在利用美国大型数据库，在既往发表文献的基础上进一步深入探讨。方法：本研究采用一项大型商业保险数据库，通过医院数据中的ICD-10编码确定脑膜瘤病例，并依据药品报销数据确定MPA暴露情况。对照组按年龄、入组年份和入组时长以10:1的比例与病例组进行匹配。采用条件逻辑回归模型估计MPA暴露与脑膜瘤发病风险之间的比值比（OR）。结果：在117,503例脑膜瘤病例和1,072,907例匹配对照中，口服MPA暴露与脑膜瘤风险无显著关联；然而注射用MPA暴露使病例风险增加53%（OR 1.53，95% CI 1.40–1.67）。这种关联性在脑膜瘤中表现尤为显著（OR 1.68，95% CI 1.50–1.87），且随着注射用MPA使用时间的延长，关联性进一步增强。结论：本研究结果与既往文献一致，均表明注射用MPA暴露与脑膜瘤存在关联，且随着MPA使用量的增加关联性更强。应警示女性长期使用MPA的风险，未来研究需进一步探讨MPA长期使用是否与脑膜瘤分级存在关联。
The Association between Medroxyprogesterone Acetate Exposure and Meningioma
肿瘤(癌症)患者之家