The Amaéva poses the question of meningiomas under Androcur treatment.
Androcur is a drug that has been prescribed a lot out of AMM, against endometriosis for example, and which increases the risk of brain tumors. He is certainly responsible for the analysis of the removed tumor shows progesterone receptors.
A study by the CNAM released in the summer of 2018 shows that this drug has an important over-risk to create meningiomas. Studies are underway for Lotéran, Lotényl and other progestins. The ANSM has already given alerts in early 2019. The risk must however be quantified, as was the case for Androcur, with the study of the CNAM released in the summer of 2018 .
Are patients warned?
What are the patients who have been warned by their doctor at the risk of meningiomas under Androcur since the change of instructions in 2011?
As much as we can understand that a general practitioner is not aware of the potentially serious effects of all the drugs he prescribes, as much it is unacceptable on the part of professionals specializing in gynecology, who do not have a spectrum of drugs so extensive than that. Even the neurosurgeons were not all aware, and while Professor Froelich has alert in congresses since 2007.
Why did information not go?
Why did these meningiomas under Androcur take so long to be identified?
It takes a frank and honest dialogue with gynecologists, that gynecologists are not in the denial of what these drugs can cause as serious problems, and that the benefit/risk balance is evaluated for each situation.
Drugs save lives, allow endometriosis in the case of facilitating everyday life. However, these drugs do not heal endometriosis, and studies on endometriosis must finally be done to understand their origin and the mechanism. Likewise for meningiomas, it still takes studies to understand why some women are developing meningiomas under Androcur and others not.
Scenario
Currently, there are two cases:
- Either the woman does not have a detected meningiomal, and takes these hormonal treatments: do not panic, she must be attentive (and her doctor too) to the neurological signs that could make one think of a cerebral involvement.
Knowing that meningiomas can remain silent for years before being talked about.
So do not hesitate to ask for a brain MRI in case of doubt . - Either the woman has one or more meningiomas, and if they are not operated (and therefore the not analyzed but just monitored tumor), prudence requires stopping any hormonal treatment.
This implies a dialogue with the gynecologist to define the possibilities.
We always come back to the primordial relationship between the doctor and the patient .
You have to hope that with the ANSM alerts, relayed by the media and associations, the information will finally be given to women.
- To read on the ASM website: Letter to health professionals New conditions of prescription and delivery of specialties based on cyproterone acetate dosed at 50 or 100 mg (Androcur and its generics).
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