What is the role of rasburicase in the treatment of hyperuricemia?

Updated: Aug 31, 2018
  • Author: James W Lohr, MD; Chief Editor: Vecihi Batuman, MD, FASN  more...
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Answer

Rasburicase (Elitek), a recombinant urate oxidase, is approved for use in preventing complications of hyperuricemia during the tumor lysis syndrome in both adults and children. It facilitates the conversion of urate to a more soluble product, allantoin. Although rasburicase treatment has become the standard of care for patients at high risk of tumor lysis syndrome, debate continues on whether the profound and rapid lowering of plasma uric acid levels produced by rasburicase has a significant effect on patient outcomes (eg, need for renal replacement therapy and mortality). [33]

Higher doses than usual of rasburicase (600-900 mg/d) are administered to decrease uric acid production prior to chemotherapy in patients with leukemias and lymphomas; allopurinol and hydration are continued for several days. If acute renal failure develops despite these measures, then early hemodialysis is indicated to reduce the total body burden of uric acid, thereby facilitating recovery of renal function.


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