title: Long-term allopurinol use decreases the risk of prostate cancer in patients with gout: a population-based study.
abstract: 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.
  
  
  
  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.
  
  
  
  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).
  
  
  
  Long-term (more than 1 year) allopurinol use may associate with a decreased risk of prostate cancer in gout patients.
authors.affiliation: Division of Urology, Department of Surgery, Changhua Christian Hospital, Changhua, Taiwan.|School of Medicine, Chung Shan Medical University, Taichung, Taiwan.|School of Medicine, Kaohsiung Medical University, Kaohsiung, Taiwan.
authors.forename: H-J
authors.initials: HJ
authors.lastname: Shih
authors.affiliation: Department of Anesthesiology, Taipei Tzu Chi Hospital, Taipei, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: M-C
authors.initials: MC
authors.lastname: Kao
authors.affiliation: Graduate Institute of Nursing, College of Nursing, Taipei Medical University, Taipei, Taiwan.
authors.forename: P-S
authors.initials: PS
authors.lastname: Tsai
authors.affiliation: Department of Anesthesiology, Taipei Tzu Chi Hospital, Taipei, Taiwan.
authors.forename: Y-C
authors.initials: YC
authors.lastname: Fan
authors.affiliation: Department of Anesthesiology, Taipei Tzu Chi Hospital, Taipei, Taiwan.|School of Medicine, Tzu Chi University, Hualien, Taiwan.
authors.forename: C-J
authors.initials: CJ
authors.lastname: Huang
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000493:Allopurinol / Q000494:pharmacology / Q000627:therapeutic use*; D016022:Case-Control Studies; D006073:Gout / Q000188:drug therapy*; D006074:Gout Suppressants / Q000494:pharmacology / Q000627:therapeutic use*; D006801:Humans; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D011471:Prostatic Neoplasms / Q000517:prevention & control*; D012307:Risk Factors
chemical_list: D006074:Gout Suppressants; D000493:Allopurinol