A Matched Case-Control Study Examining the Association Between Exposure to Depot Medroxyprogesterone Acetate and Cerebral Meningioma Using an Active Comparator

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.