Association of alpha-1-adrenergic antagonist use with the risk of gout development in benign prostatic hyperplasia patients: a population-based cohort study

Abstract

Abstract Background Men are more likely to develop benign prostatic hyperplasia (BPH) and gout as they age. However, the role of alpha-1-adrenergic antagonists, the medication for BPH, in the development of gout is uncertain. Objective To investigate the effect of alpha-1-adrenergic antagonist use on the risk of developing gout in BPH patients. Methods Data of patients with newly diagnosed BPH were retrieved from Taiwan’s 2000–2013 National Health Insurance Research Database (total number: 15,390 patients; 7,695 patients in each cohort). Propensity score matching was conducted according to age, comorbidities, medication history for cohorts that received or did not receive alpha-1-adrenergic antagonists. Hazard ratios (HRs) were assessed for gout development using Cox proportional hazards regression models. Results Use of alpha-1-adrenergic antagonists was not associated with gout development in BPH patients (HR = 0.92; 95% confidence interval [CI], 0.78–1.10; P = 0.35). However, after stratification according to the average number of days of alpha-1-adrenergic antagonist use per year, patients with an average of >300 days had a significantly higher risk of gout development than patients who did not receive alpha-1-adrenergic antagonists (adjusted HR = 1.57; 95% CI, 1.25–1.97; P < 0.001). Patients with more days of medication use per year had a higher risk of gout development than those with fewer days of medication use (P < 0.001). Conclusion Patients who received more doses of alpha-1-adrenergic antagonists per year had a higher risk of developing gout. A causal proof of the role of alpha-1-adrenergic antagonists use in gout development should be analysed in future studies designed as double blind randomized controlled trials.