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FORMULARY FORUM

Rasburicase for the Treatment and Prevention of Hyperuricemia

Clinical Assistant Professor, College of Pharmacy, Department of Pharmacy Practice, University of Illinois at Chicago, Chicago, IL; Clinical Adjunct Instructor, Chicago College of Pharmacy, Midwestern University, Downers Grove, IL; Clinical Pharmacist, Department of Pharmacy, John H Stroger Jr Hospital of Cook County, Chicago

Rosalyn P Sims-McCallum, PharmD

Adjunct Assistant Professor, College of Pharmacy and Allied Health Professions, Wayne State University, Detroit, MI; Clinical Pharmacy Specialist, Department of Pharmacy, Children's Hospital of Michigan, Detroit

Pang H Chong, PharmD

Clinical Coordinator, John H Stroger Jr Hospital of Cook County; Clinical Assistant Professor, Department of Pharmacy Practice, University of Illinois at Chicago; Clinical Adjunct Instructor, Chicago College of Pharmacy, Midwestern University, Downers Grove, IL

Reprints: Barbara T Yim PharmD, Department of Pharmacy, LL170, John H Stroger Jr Hospital of Cook County, 1901 W. Harrison Ave., Chicago, IL 60612-3736, FAX 312/864-9287, E-mail abtysy{at}msn.com

OBJECTIVE: To review the information currently available on rasburicase for treatment and prevention of hyperuricemia.

DATA SOURCES: MEDLINE (1966–August 2002) was searched for primary and review articles.

STUDY SELECTION/DATA EXTRACTION: Studies evaluating rasburicase, including abstracts and proceedings, were considered for inclusion. English-language literature was evaluated for the pharmacology, pharmacodynamics, pharmacokinetics, therapeutic use, and adverse effects of rasburicase.

DATA SYNTHESIS: Rasburicase, a recombinant urate oxidase, has been shown to be effective in lowering uric acid and preventing uric acid accumulation in patients with hematologic malignancies who had hyperuricemia or who were at high risk for developing hyperuricemia. It has been approved for pediatric use in the US.

CONCLUSIONS: In addition to allopurinol, hydration, and urinary alkalinization, rasburicase is a new alternative for the treatment and prevention of hyperuricemia in patients with hematologic malignancies. Its rapid onset of action and the ability to lower preexisting elevated uric acid levels are the advantages of rasburicase compared with allopurinol. It may allow the patient to receive chemotherapy treatment without delay.

Key Words: rasburicase, SR29142, urate oxidase

Published Online, June 23, 2003. www.theannals.com, DOI 10.1345/aph.1C336

THIS ARTICLE IS APPROVED FOR CONTINUING EDUCATION CREDIT
ACPE UNIVERSAL PROGRAM NUMBER: 407-000-03-016-H01

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