台灣老人髖部骨折與使用Allopurinol的研究

Hip Fracture and Allopurinol Use in Older People in a Case-control Study in Taiwan

目的：探討老人髖部骨折與使用Allopurinol的關係。 方法：利用2000年至2013年台灣健保資料執行一個病例對照研究。病例組為65歲或以上老人有新診斷髖部骨折者，對照組為65歲或以上老人沒有髖部骨折者。使用Allopurinol的定義如下：最後一次Allopurinol處方日與髖部骨折發生日的間距小於3個月者列為：目前使用。最後一次Allopurinol處方日與髖部骨折發生日的間距介於3-6個月者列為：最近使用。最後一次Allopurinol處方日與髖部骨折發生日的間距大於或等於6個月者列為：過去使用。使用多變項邏輯斯迴歸分析來檢定老人髖部骨折與使用Allopurinol的關係。 結果：病例組包含8,012個老人有新診斷髖部骨折，對照組包含8,012個老人沒有髖部骨折。多變項邏輯斯迴歸分析發現，不論是目前使用Allopurinol、最近使用Allopurinol或過去使用Allopurinol，皆與老人髖部骨折沒有相關性。 結論：台灣老人髖部骨折與使用Allopurinol沒有相關性。

 

Purpose: There is still debate on the risk of hip fractures associated with allopurinol use. This study aimed to assess whether there was a relationship between the risk of hip fractures and allopurinol use in older people in Taiwan. Methods: We performed a nation-based case-control study using the database of the Taiwan National Health Insurance Program. Subjects ≥ 65 years with a newly-diagnosed hip fracture between 2000-2013 were identified as the cases. Sex-matched and age-matched subjects ≥ 65 years without a hip fracture were randomly selected as the controls. Allopurinol use was defined as “current”, “recent” or “past” if the allopurinol prescription was filled < 3 months, 3-6 months or ≥ 6 months before the index date, respectively. We used a multivariable logistic regression model to calculate the odds ratio (OR) and 95% confidence interval (CI) for hip fracture being associated with allopurinol use. Results: There were 8,012 cases with a newly-diagnosed hip fracture, and there were 8,012 controls without a hip fracture. The mean age was 79 years and 61% were women. After adjusting for potential covariables, there was no statistical association between a hip fracture and current use of allopurinol (adjusted OR 0.88, 95% CI 0.64-1.21, p= 0.44), recent use of allopurinol (adjusted OR 0.81, 95% CI 0.50-1.31, p= 0.39), or past use of allopurinol (adjusted OR 0.99, 95% CI 0.89-1.09, p= 0.08). Conclusion: No statistical association can be found between the risk of hip fractures and allopurinol use in older people in Taiwan.