Rasburicase
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|---|---|
| Systematic (IUPAC) name | |
| Aspergillus urate oxidase | |
| Clinical data | |
| AHFS/Drugs.com | monograph |
| Pregnancy cat. | ? |
| Legal status | RX/POM |
| Routes | Intravenous |
| Pharmacokinetic data | |
| Bioavailability | N/A |
| Half-life | 18 hrs |
| Identifiers | |
| CAS number | 134774-45-1  |
| ATC code | V03AF07 |
| DrugBank | BIOD00090 |
| UNII | 08GY9K1EUO |
| ChEMBL | CHEMBL1201594  |
| Chemical data | |
| Formula | C1521H2381N417O461S7 |
| Mol. mass | 34109.5 |
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Rasburicase (brand names: Elitek in the US, and Fasturtec in Europe ) is a recombinant version of urate oxidase, an enzyme which occurs in many mammals but not in humans.
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[edit] Uses
Rasburicase is approved for use by the U.S. Food and Drug Administration (FDA) (and European counterparts) for the prevention and treatment of tumor lysis syndrome (TLS)[1] in patients receiving chemotherapy for hematologic cancers such as leukemias and lymphomas. It is also being investigated for treating severe hyperuricemia from other sources (e.g., gout[2] and other rheumatologic conditions).
It catalyses the conversion of uric acid to allantoin. Allantoin is an inactive metabolite of purine metabolism, and is five to ten times more soluble than uric acid, so renal excretion is more effective. Rasburicase is unique as a treatment and prevention for renal failure associated with TLS in that it catalyses the metabolism of existing uric acid. Other options prevent uric acid formation.
Rasburicase reduces the risk of renal failure and the need for transfusion. Transfusion has been reported as required in 17 to 25% of TLS cases treated with allopurinol, and 1.4% of cases treated with rasburicase.[citation needed]
However, rasburicase is much more expensive than conventional therapy.[3]
[edit] Side effects
Side effects of rasburicase administration can include anaphylaxis (incidence unknown) and methemoglobinemia.
[edit] See also
- Allopurinol is also indicated for TLS to reduce the blood concentration of uric acid.[citation needed]
- Pegloticase is a pegylated variant of the uricase enzyme which has been approved for the treatment of refractory gout.
[edit] References
- ^ Ho VQ, Wetzstein GA, Patterson SG, Bradbury R (April 2006). "Abbreviated rasburicase dosing for the prevention and treatment of hyperuricemia in adults at risk for tumor lysis syndrome". Supportive cancer therapy 3 (3): 178–82. doi:10.3816/SCT.2006.n.016. PMID 18632493. http://cigjournals.metapress.com/openurl.asp?genre=article&id=doi:10.3816/SCT.2006.n.016.
- ^ Cammalleri L, Malaguarnera M (2007). "Rasburicase represents a new tool for hyperuricemia in tumor lysis syndrome and in gout". International journal of medical sciences 4 (2): 83–93. PMC 1838823. PMID 17396159. http://www.medsci.org/v04p0083.htm.
- ^ Reinders MK, van Roon EN, Brouwers JR, Jansen TL (March 2005). "A costly therapeutic dilemma in tophaceous gout: is etanercept or rasburicase preferable?". Annals of the rheumatic diseases 64 (3): 516; author reply 516. doi:10.1136/ard.2003.017087corr1. PMC 1755382. PMID 15708917. http://ard.bmj.com/cgi/pmidlookup?view=long&pmid=15708917.
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[edit] External links
- Elitek (Rasburicase) - Official web site of manufacturer.
- Elitek (Rasburicase) Prescribing Information - Official Prescribing Information of manufacturer.
- [1] - Elitek (Rasburicase)
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