Objective: The study aimed to thoroughly address the influence of
benzbromarone and
allopurinol on the risk of the development of
type 2 diabetes mellitus (T2DM) in people with asymptomatic
hyperuricemia. Methods: We conducted a retrospective cohort study to examine the 2000-2015 national dataset containing all claims data of 23 million beneficiaries in Taiwan. Subjects who already had
diabetes mellitus,
gout-related diseases, and any
cancer prior to the index date were excluded. Asymptomatic
hyperuricemia was defined as subjects taking
urate-lowering drugs who never had a
gout flare. Subjects aged 20-84 with asymptomatic
hyperuricemia who had
benzbromarone prescriptions were selected as the
benzbromarone group. Sex-matched and age-matched subjects with asymptomatic
hyperuricemia who had
allopurinol prescriptions were identified as the
allopurinol group. The maximum follow-up duration was set as 5 years in our study. The outcome was set as subjects who had a new diagnosis of T2DM. The incidence density of T2DM was calculated in the
benzbromarone and
allopurinol groups. The hazard ratio (HR) and 95% confidence interval (CI) for T2DM was utilized to estimate the association between medications and the risk of T2DM. Results: The incidence of T2DM among
benzbromarone users was significantly lower than that of
allopurinol users (7.91 versus 8.48 per 100 person-years, incidence rate ratio = 0.93, and 95% CI = 0.87-0.99). After adjustment for co-variables, the adjusted HR of T2DM would be 0.91 (95% CI = 0.85-0.98 and p = 0.008) in
benzbromarone users as compared to
allopurinol users. Conclusion: There is a small but statistically significant risk reduction of developing T2DM in people with asymptomatic
hyperuricemia taking
benzbromarone as compared to those taking
allopurinol during 5 years of follow-up. It indicates a future research direction for the use of individual
urate-lowering drugs on the prevention of T2DM in the general population.