安樂普諾錠降低痛風病人罹患攝護腺癌的風險：人口為基礎的研究

陳昭安¹、石宏仁¹

¹彰化基督教醫院外科部泌尿科

Allopurinol decreases the risk of prostate cancer in patients with gout: A population-based study

Cho-An Chen¹, Hung-Jen Shih, MD, PhD. ¹

¹Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan

Purpose: Clinical observations indicated an increased risk of developing prostate cancer in gout patients. Chronic inflammation is postulated to be one crucial risk factor for prostate carcinogenesis. Allopurinol, a widely used anti-gout agent, possesses potent anti-inflammation capacity. We conducted this population-based cohort study to elucidate whether allopurinol decreases the risk of prostate cancer in gout patients.

Materials and Methods: We analyzed data retrieved from Taiwan National Health Insurance Database between January, 2000 and December, 2012. Patients who diagnosed with gout during the study period, no history of prostate cancer and never used allopurinol were selected. Two cohorts (allopurinol-treated and allopurinol-untreated) were included. The study end point was the primary diagnosis of new-onset prostate cancer. The multivariable Cox proportional hazards regression and propensity score-adjusted Cox regression models were used to estimate the association between the risk of prostate cancer and allopurinol treatment in gout patients after adjusting for potential confounders.

Results: A total of 22923 gout patients (aged between 40 and 100 years) were included. The mean time to prostate cancer occurrence was significantly longer in allopurinol-treated cohort than allopurinol-untreated cohort (7.2±3.45 vs. 5.42±3.65 years; P<0.001). Multivariable Cox regression analyses revealed that the risk of developing prostate cancer in allopurinol-treated cohort was significantly lower than the allopurinol-untreated cohort (adjusted hazard ratio [HR] = 0.63, 95% confidence interval [CI] = 0.49-0.81, P<0.001). After propensity score adjustment, the trend remained the same (adjusted HR = 0.65, 95% CI= 0.5-0.83, P=0.001). 　

Conclusions: Allopurinol significantly decreases the risk of prostate cancer in gout patients.