Association between allopurinol use and hip fracture in older patients

Ujani Basu, James Goodbrand, Marion E. T. McMurdo, Peter T. Donnan, Mark McGilchrist, Helen Frost, Jacob George, Miles D. Witham (Lead / Corresponding author)

    Research output: Contribution to journalArticle

    6 Citations (Scopus)
    44 Downloads (Pure)

    Abstract

    Background: Allopurinol reduces oxidative stress and interacts with purinergic signalling systems important in bone metabolism and muscle function. We assessed whether allopurinol use was associated with a reduced incidence of hip fracture in older people.

    Methods: Analysis of prospective, routinely-collected health and social care data on patients undergoing health and social work assessment in a single geographical area over a 12 year period. Exposure to allopurinol was derived from linked community prescribing data, hospitalisation for hip fracture and comorbid disease was derived from linked hospitalisation data. Fine and Gray modelling was used to model time to hip fracture accounting for the competing risk of death, incorporating previous use of allopurinol, cumulative exposure to allopurinol as a time dependent variable, and covariate adjustments.

    Results: 17308 patients were alive at the time of first social work assessment without previous hip fracture; the mean age was 73 years. 10171 (59%) were female, and 1155 (8%) had at least one exposure to allopurinol. 618 (3.6%) sustained a hip fracture, and 4226 (24%) died during a mean follow up of 7.2 years. In fully-adjusted analyses, each year of allopurinol exposure conferred a hazard ratio of 1.01 (95% CI 0.99, 1.02; p=0.37) for hip fracture and 1.00 (0.99, 1.01; p=0.47) for death. Previous use of allopurinol conferred a hazard ratio of 0.76 (0.45, 1.26; p=0.28) for hip fracture and 1.13 (0.99, 1.29; p=0.07) for death.

    Conclusion: Greater cumulative use of allopurinol was not associated with a reduced risk of hip fracture or death in this cohort.
    Original languageEnglish
    Pages (from-to)189-193
    Number of pages5
    JournalBone
    Volume84
    Early online date6 Jan 2016
    DOIs
    Publication statusPublished - Mar 2016

    Fingerprint

    Allopurinol
    Hip Fractures
    Social Work
    Hospitalization
    Oxidative Stress
    Delivery of Health Care
    Bone and Bones
    Muscles
    Incidence

    Keywords

    • Gout
    • Fracture
    • older
    • Allopurinol
    • risk factor

    Cite this

    @article{d67afa49c80740028f732e434d70d702,
    title = "Association between allopurinol use and hip fracture in older patients",
    abstract = "Background: Allopurinol reduces oxidative stress and interacts with purinergic signalling systems important in bone metabolism and muscle function. We assessed whether allopurinol use was associated with a reduced incidence of hip fracture in older people.Methods: Analysis of prospective, routinely-collected health and social care data on patients undergoing health and social work assessment in a single geographical area over a 12 year period. Exposure to allopurinol was derived from linked community prescribing data, hospitalisation for hip fracture and comorbid disease was derived from linked hospitalisation data. Fine and Gray modelling was used to model time to hip fracture accounting for the competing risk of death, incorporating previous use of allopurinol, cumulative exposure to allopurinol as a time dependent variable, and covariate adjustments.Results: 17308 patients were alive at the time of first social work assessment without previous hip fracture; the mean age was 73 years. 10171 (59{\%}) were female, and 1155 (8{\%}) had at least one exposure to allopurinol. 618 (3.6{\%}) sustained a hip fracture, and 4226 (24{\%}) died during a mean follow up of 7.2 years. In fully-adjusted analyses, each year of allopurinol exposure conferred a hazard ratio of 1.01 (95{\%} CI 0.99, 1.02; p=0.37) for hip fracture and 1.00 (0.99, 1.01; p=0.47) for death. Previous use of allopurinol conferred a hazard ratio of 0.76 (0.45, 1.26; p=0.28) for hip fracture and 1.13 (0.99, 1.29; p=0.07) for death.Conclusion: Greater cumulative use of allopurinol was not associated with a reduced risk of hip fracture or death in this cohort.",
    keywords = "Gout, Fracture, older, Allopurinol, risk factor",
    author = "Ujani Basu and James Goodbrand and McMurdo, {Marion E. T.} and Donnan, {Peter T.} and Mark McGilchrist and Helen Frost and Jacob George and Witham, {Miles D.}",
    note = "UB received funding from the Dundee Clinical Academic Track summer programme to carry out part of this work; the database linkage work was funded by the Scottish Collaboration for Public Health Research and Policy, grant number SCPH/10.",
    year = "2016",
    month = "3",
    doi = "10.1016/j.bone.2016.01.003",
    language = "English",
    volume = "84",
    pages = "189--193",
    journal = "Bone",
    issn = "8756-3282",
    publisher = "Elsevier",

    }

    Association between allopurinol use and hip fracture in older patients. / Basu, Ujani; Goodbrand, James ; McMurdo, Marion E. T.; Donnan, Peter T.; McGilchrist, Mark; Frost, Helen; George, Jacob; Witham, Miles D. (Lead / Corresponding author).

    In: Bone, Vol. 84, 03.2016, p. 189-193.

    Research output: Contribution to journalArticle

    TY - JOUR

    T1 - Association between allopurinol use and hip fracture in older patients

    AU - Basu, Ujani

    AU - Goodbrand, James

    AU - McMurdo, Marion E. T.

    AU - Donnan, Peter T.

    AU - McGilchrist, Mark

    AU - Frost, Helen

    AU - George, Jacob

    AU - Witham, Miles D.

    N1 - UB received funding from the Dundee Clinical Academic Track summer programme to carry out part of this work; the database linkage work was funded by the Scottish Collaboration for Public Health Research and Policy, grant number SCPH/10.

    PY - 2016/3

    Y1 - 2016/3

    N2 - Background: Allopurinol reduces oxidative stress and interacts with purinergic signalling systems important in bone metabolism and muscle function. We assessed whether allopurinol use was associated with a reduced incidence of hip fracture in older people.Methods: Analysis of prospective, routinely-collected health and social care data on patients undergoing health and social work assessment in a single geographical area over a 12 year period. Exposure to allopurinol was derived from linked community prescribing data, hospitalisation for hip fracture and comorbid disease was derived from linked hospitalisation data. Fine and Gray modelling was used to model time to hip fracture accounting for the competing risk of death, incorporating previous use of allopurinol, cumulative exposure to allopurinol as a time dependent variable, and covariate adjustments.Results: 17308 patients were alive at the time of first social work assessment without previous hip fracture; the mean age was 73 years. 10171 (59%) were female, and 1155 (8%) had at least one exposure to allopurinol. 618 (3.6%) sustained a hip fracture, and 4226 (24%) died during a mean follow up of 7.2 years. In fully-adjusted analyses, each year of allopurinol exposure conferred a hazard ratio of 1.01 (95% CI 0.99, 1.02; p=0.37) for hip fracture and 1.00 (0.99, 1.01; p=0.47) for death. Previous use of allopurinol conferred a hazard ratio of 0.76 (0.45, 1.26; p=0.28) for hip fracture and 1.13 (0.99, 1.29; p=0.07) for death.Conclusion: Greater cumulative use of allopurinol was not associated with a reduced risk of hip fracture or death in this cohort.

    AB - Background: Allopurinol reduces oxidative stress and interacts with purinergic signalling systems important in bone metabolism and muscle function. We assessed whether allopurinol use was associated with a reduced incidence of hip fracture in older people.Methods: Analysis of prospective, routinely-collected health and social care data on patients undergoing health and social work assessment in a single geographical area over a 12 year period. Exposure to allopurinol was derived from linked community prescribing data, hospitalisation for hip fracture and comorbid disease was derived from linked hospitalisation data. Fine and Gray modelling was used to model time to hip fracture accounting for the competing risk of death, incorporating previous use of allopurinol, cumulative exposure to allopurinol as a time dependent variable, and covariate adjustments.Results: 17308 patients were alive at the time of first social work assessment without previous hip fracture; the mean age was 73 years. 10171 (59%) were female, and 1155 (8%) had at least one exposure to allopurinol. 618 (3.6%) sustained a hip fracture, and 4226 (24%) died during a mean follow up of 7.2 years. In fully-adjusted analyses, each year of allopurinol exposure conferred a hazard ratio of 1.01 (95% CI 0.99, 1.02; p=0.37) for hip fracture and 1.00 (0.99, 1.01; p=0.47) for death. Previous use of allopurinol conferred a hazard ratio of 0.76 (0.45, 1.26; p=0.28) for hip fracture and 1.13 (0.99, 1.29; p=0.07) for death.Conclusion: Greater cumulative use of allopurinol was not associated with a reduced risk of hip fracture or death in this cohort.

    KW - Gout

    KW - Fracture

    KW - older

    KW - Allopurinol

    KW - risk factor

    U2 - 10.1016/j.bone.2016.01.003

    DO - 10.1016/j.bone.2016.01.003

    M3 - Article

    VL - 84

    SP - 189

    EP - 193

    JO - Bone

    JF - Bone

    SN - 8756-3282

    ER -