Rasburicase is a drug used to prevent and treat hyperuricemia caused by tumor lysis syndrome. Its English name is Fasturtec, and its other nicknames include Rasburicase and Elitek. Developed by Sanofi-Aventis of France, it was launched in the UK and Germany in March 2001 and later approved by the US FDA. The dosage form is a lyophilized powder injection. The main ingredient is Rasburicase. It is suitable for the initial management of plasma uric acid in patients with leukemia, lymphoma, etc. who are receiving anti-cancer treatment.
Rasburicase (Fasturtec/ELITEK) has a good effect in the treatment of hyperuricemia
Rasburicase has shown significant clinical value in the treatment of hyperuricemia. Its mechanism of action and clinical application effect provide key treatment support for patients with tumor lysis syndrome.
Mechanism of catalyzing the decomposition of uric acid
The main target of Rasburicase is uric acid. As a urate oxidase, it can specifically catalyze the decomposition of uric acid into more water-soluble allantoin and hydrogen peroxide. The solubility of allantoin is 5-10 times that of uric acid. It can be rapidly excreted through the kidneys, thereby significantly reducing plasma uric acid concentration in a short period of time, effectively preventing uric acid crystals from depositing in the kidneys and other tissues, and avoiding complications such as acute renal injury.
Clinical application effect of rapid uric acid reduction
Rasburicase is suitable for children and adults with leukemia, lymphoma and malignant solid tumors. When receiving anti-cancer treatment, tumor cell lysis will cause a sharp increase in plasma uric acid. The drug can be used before chemotherapy or in the early stages of chemotherapy to achieve the best therapeutic effect. Clinical studies have shown that it can reduce uric acid levels to normal within 24-48 hours, especially for patients who are ineffective or intolerant to allopurinol treatment, and can be used as a first-line treatment option.
After understanding the therapeutic effect of Rasburicase, clarifying its applicable population is an important prerequisite for safe and effective medication. The following are specific applicable objects and medication points.
Applicable population of Rasburicase
The applicable population of Rasburicase needs to be comprehensively judged in combination with the type of disease and the stage of treatment to ensure that the drug is effective in the appropriate clinical scenario.
Pediatric tumor patients
The safety and efficacy of Rasburicase have been confirmed in pediatric patients aged 1 month to 17 years. It can be used for the initial management of plasma uric acid levels in children with leukemia, lymphoma and malignant solid tumors during anticancer treatment to control the increase in uric acid caused by tumor lysis. It should be noted that the number of patients aged 0 to 6 months is insufficient (n=7), and the rate of children <2 years old reaching normal uric acid concentration within 48 hours is lower than that of children aged 2 to 17 years.
Adult tumor patients
Rasburicase can be used for the initial management of plasma uric acid levels in adult patients with leukemia, lymphoma and malignant solid tumors when receiving anticancer treatment if tumor lysis and subsequent increase in plasma uric acid are expected. In clinical studies, no overall differences in pharmacokinetics, safety and efficacy were observed between elderly and young adult patients, and the same dosage and medication specifications should be followed when used by adults.
Patients at a specific treatment stage
Rasburicase should be used before chemotherapy or in the early stages of chemotherapy to achieve the best therapeutic effect, helping patients to control uric acid levels before tumor lysis causes an increase in uric acid, reducing the risk of hyperuricemia and its complications, and providing support for anti-cancer treatment.
In addition to understanding the applicable population, patients also need to understand the potential safety issues of the drug. The following is relevant information about Rasburicase in terms of carcinogenicity, mutagenesis, and fertility impairment.
Rasburicase carcinogenicity, mutagenesis, and fertility impairment
There is limited research data on the carcinogenicity, mutagenesis, and fertility impairment of Rasburicase. The following is a summary of the existing information.
Carcinogenicity and mutagenesis research
There is currently no long-term animal research data on the carcinogenicity of Rasburicase, and it is impossible to determine whether it is carcinogenic. In terms of mutagenesis tests, existing studies have not found that Rasburicase is genotoxic, but the relevant test data are not sufficient, and more research is needed to further verify it.
Potential effects on fertility
In terms of fertility impairment, animal studies have shown that Rasburicase has no direct effect on the fertility of male and female animals, but the limited available data on the use of Rasburicase in pregnant women are insufficient to inform the risk of major drug-related birth defects, miscarriage, or adverse maternal and fetal outcomes. Males and females of reproductive potential should use Rasburicase under the guidance of a physician to fully assess the risks and benefits of the medication.
