依據台灣腎臟學會雜誌1統計，台灣患末期腎臟疾病(ESRD)須透析的病人數於2002年首度居世界之冠，且逐年增加約八千人。而藥物造成的腎衰竭又可因藥物種類、來源不同與毒性不同，對腎臟所造成的損傷程度亦不同。本研究的目的，從分析痛風與腎衰竭的關係，以allopurinol的學名藥及原廠藥共五類藥品，來分析在五年的健保資料庫中洗腎的機率。從而提出預防方法，以降低國人洗腎人數，進而降低政府的醫療健保費用支出。採用國家衛生研究院所提供的全國健康保險資料庫，從西元2005年到2009年之間，對 Allopurinol的學名藥及原廠藥作用在痛風病人的影響之回朔性研究。從39,716位痛風病人中，分成兩組。一組有服用allopurinol為實驗組，另一組對照組為無服用allopurinol。實驗組分為5個次組別：學名藥、PIC/S GMP學名藥、BA/BE學名藥、PIC/S GMP BA/BE學名藥、和原廠藥 allopurinol。使用SPSS 12.0版之邏吉斯回歸方程式評估odds ratio與95%可信賴區間的計算，P值<0.01有統計上意義。由健保資料庫篩出痛風病人服用allopurinol治療高尿酸血症人數是5623(6.4%)。服用allopurinol產生腎衰竭的人數是607(10.8%)。服用allopurinol產生紅斑的人數是65(1.2%)。對照組無服用allopurinol但有得到腎病的的人數是4157(5.576%)。不管用allopurinol學名藥或原廠藥，對高尿酸血症的人，每年2~3次的定期腎功能檢查是需要的。 According to a statistical analysis by the Taiwan Society of Nephrology, Taiwan once had the world’s highest incidence of patients dependent on hemodialysis. The incidence of renal failure caused by medication depends on the various kinds of medicines consumed by the patient and their origins. The purpose of this study is to use the Taiwan National Health Insurance Research Database to compare the kidney failure rates of gouty patients taking generic and brand name allopurinol. 39,716 gouty patients were assigned to five experimental sub-groups who took generic, PIC/S GMP generic, BA/BE generic, PIC/S GMP BA/BE generic, and brand name allopurinol; the counterpart group took no allopurinol. Logistic regression analysis is used. Odds ratio estimates and 95% confidence intervals were calculated using SPSS 12.0, with P values < 0.01 considered statistically significant. The number of gouty patients taking allopurinol to treat their hyperuricemia was 5,623(6.4%). A total number of 607(10.8%) cases of renal failure or 65(1.2%) cases of erythema multiforme patients taking allopurinol were identified. Among the control group, cases of renal failure numbered 4,157(5.6%). Even without taking any allopurinol, it is necessary that hyperurecemia patients have their kidney function checked at least two to three times each year.
