Long-term allopurinol use decreases the risk of prostate cancer in patients with gout: a population-based study

H-J Shih, M-C Kao, P-S Tsai, Y-C Fan, C-J Huang

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

BACKGROUND: Clinical observations indicated an increased risk of developing prostate cancer in gout patients. Chronic inflammation is postulated to be one crucial mechanism for prostate carcinogenesis. Allopurinol, a widely used antigout agent, possesses potent anti-inflammation capacity. We elucidated whether allopurinol decreases the risk of prostate cancer in gout patients.

METHODS: We analyzed data retrieved from Taiwan National Health Insurance Database between January 2000 and December 2012. Patients diagnosed with gout during the study period with no history of prostate cancer and who had never used allopurinol were selected. Four allopurinol use cohorts (that is, allopurinol use (>365 days), allopurinol use (181-365 days), allopurinol use (91-180 days) and allopurinol use (31-90 days)) and one cohort without using allopurinol (that is, allopurinol use (No)) were included. The study end point was the diagnosis of new-onset prostate cancer. 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 25 770 gout patients (aged between 40 and 100 years) were included. Multivariable Cox regression analyses revealed that the risk of developing prostate cancer in the allopurinol use (>365 days) cohort was significantly lower than the allopurinol use (No) cohort (adjusted hazard ratio (HR)=0.64, 95% confidence interval (CI)=0.45-0.9, P=0.011). After propensity score adjustment, the trend remained the same (adjusted HR=0.66, 95% CI=0.46-0.93, P=0.019).

CONCLUSIONS: Long-term (more than 1 year) allopurinol use may associate with a decreased risk of prostate cancer in gout patients.Prostate Cancer and Prostatic Diseases advance online publication, 11 April 2017; doi:10.1038/pcan.2017.14.

Original languageEnglish
JournalProstate Cancer and Prostatic Diseases
DOIs
Publication statusE-pub ahead of print - Apr 11 2017

Fingerprint

Allopurinol
Gout
Prostatic Neoplasms
Population
Propensity Score
Gout Suppressants
Prostatic Diseases
Confidence Intervals
Inflammation
National Health Programs
Taiwan
Proportional Hazards Models
Publications
Prostate

Keywords

  • Journal Article

Cite this

@article{d5e2a57d14ef471295d0c83ac0af6b5f,
title = "Long-term allopurinol use decreases the risk of prostate cancer in patients with gout: a population-based study",
abstract = "BACKGROUND: Clinical observations indicated an increased risk of developing prostate cancer in gout patients. Chronic inflammation is postulated to be one crucial mechanism for prostate carcinogenesis. Allopurinol, a widely used antigout agent, possesses potent anti-inflammation capacity. We elucidated whether allopurinol decreases the risk of prostate cancer in gout patients.METHODS: We analyzed data retrieved from Taiwan National Health Insurance Database between January 2000 and December 2012. Patients diagnosed with gout during the study period with no history of prostate cancer and who had never used allopurinol were selected. Four allopurinol use cohorts (that is, allopurinol use (>365 days), allopurinol use (181-365 days), allopurinol use (91-180 days) and allopurinol use (31-90 days)) and one cohort without using allopurinol (that is, allopurinol use (No)) were included. The study end point was the diagnosis of new-onset prostate cancer. 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 25 770 gout patients (aged between 40 and 100 years) were included. Multivariable Cox regression analyses revealed that the risk of developing prostate cancer in the allopurinol use (>365 days) cohort was significantly lower than the allopurinol use (No) cohort (adjusted hazard ratio (HR)=0.64, 95{\%} confidence interval (CI)=0.45-0.9, P=0.011). After propensity score adjustment, the trend remained the same (adjusted HR=0.66, 95{\%} CI=0.46-0.93, P=0.019).CONCLUSIONS: Long-term (more than 1 year) allopurinol use may associate with a decreased risk of prostate cancer in gout patients.Prostate Cancer and Prostatic Diseases advance online publication, 11 April 2017; doi:10.1038/pcan.2017.14.",
keywords = "Journal Article",
author = "H-J Shih and M-C Kao and P-S Tsai and Y-C Fan and C-J Huang",
year = "2017",
month = "4",
day = "11",
doi = "10.1038/pcan.2017.14",
language = "English",
journal = "Prostate Cancer and Prostatic Diseases",
issn = "1365-7852",
publisher = "Nature Publishing Group",

}

TY - JOUR

T1 - Long-term allopurinol use decreases the risk of prostate cancer in patients with gout

T2 - a population-based study

AU - Shih, H-J

AU - Kao, M-C

AU - Tsai, P-S

AU - Fan, Y-C

AU - Huang, C-J

PY - 2017/4/11

Y1 - 2017/4/11

N2 - BACKGROUND: Clinical observations indicated an increased risk of developing prostate cancer in gout patients. Chronic inflammation is postulated to be one crucial mechanism for prostate carcinogenesis. Allopurinol, a widely used antigout agent, possesses potent anti-inflammation capacity. We elucidated whether allopurinol decreases the risk of prostate cancer in gout patients.METHODS: We analyzed data retrieved from Taiwan National Health Insurance Database between January 2000 and December 2012. Patients diagnosed with gout during the study period with no history of prostate cancer and who had never used allopurinol were selected. Four allopurinol use cohorts (that is, allopurinol use (>365 days), allopurinol use (181-365 days), allopurinol use (91-180 days) and allopurinol use (31-90 days)) and one cohort without using allopurinol (that is, allopurinol use (No)) were included. The study end point was the diagnosis of new-onset prostate cancer. 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 25 770 gout patients (aged between 40 and 100 years) were included. Multivariable Cox regression analyses revealed that the risk of developing prostate cancer in the allopurinol use (>365 days) cohort was significantly lower than the allopurinol use (No) cohort (adjusted hazard ratio (HR)=0.64, 95% confidence interval (CI)=0.45-0.9, P=0.011). After propensity score adjustment, the trend remained the same (adjusted HR=0.66, 95% CI=0.46-0.93, P=0.019).CONCLUSIONS: Long-term (more than 1 year) allopurinol use may associate with a decreased risk of prostate cancer in gout patients.Prostate Cancer and Prostatic Diseases advance online publication, 11 April 2017; doi:10.1038/pcan.2017.14.

AB - BACKGROUND: Clinical observations indicated an increased risk of developing prostate cancer in gout patients. Chronic inflammation is postulated to be one crucial mechanism for prostate carcinogenesis. Allopurinol, a widely used antigout agent, possesses potent anti-inflammation capacity. We elucidated whether allopurinol decreases the risk of prostate cancer in gout patients.METHODS: We analyzed data retrieved from Taiwan National Health Insurance Database between January 2000 and December 2012. Patients diagnosed with gout during the study period with no history of prostate cancer and who had never used allopurinol were selected. Four allopurinol use cohorts (that is, allopurinol use (>365 days), allopurinol use (181-365 days), allopurinol use (91-180 days) and allopurinol use (31-90 days)) and one cohort without using allopurinol (that is, allopurinol use (No)) were included. The study end point was the diagnosis of new-onset prostate cancer. 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 25 770 gout patients (aged between 40 and 100 years) were included. Multivariable Cox regression analyses revealed that the risk of developing prostate cancer in the allopurinol use (>365 days) cohort was significantly lower than the allopurinol use (No) cohort (adjusted hazard ratio (HR)=0.64, 95% confidence interval (CI)=0.45-0.9, P=0.011). After propensity score adjustment, the trend remained the same (adjusted HR=0.66, 95% CI=0.46-0.93, P=0.019).CONCLUSIONS: Long-term (more than 1 year) allopurinol use may associate with a decreased risk of prostate cancer in gout patients.Prostate Cancer and Prostatic Diseases advance online publication, 11 April 2017; doi:10.1038/pcan.2017.14.

KW - Journal Article

U2 - 10.1038/pcan.2017.14

DO - 10.1038/pcan.2017.14

M3 - Article

C2 - 28398294

JO - Prostate Cancer and Prostatic Diseases

JF - Prostate Cancer and Prostatic Diseases

SN - 1365-7852

ER -