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Rasburicase (Elitek) is an enzyme infusion that rapidly dissolves the uric acid released when large numbers of leukaemia or lymphoma cells die at the start of treatment, protecting the kidneys from tumour lysis syndrome.
Rasburicase was approved by the FDA in July 2002 for initial management of plasma uric acid in children (adults added 2009) with leukaemia, lymphoma or solid tumours receiving therapy expected to cause tumour lysis, on randomised trials against allopurinol in which uric acid normalised within four hours in almost all patients; the EU authorised Fasturtec in 2001. It is standard for high-risk tumour lysis syndrome (Burkitt lymphoma, high-count ALL and AML, venetoclax ramp-up in CLL with bulky disease), often as a single dose rather than the labelled five days. Haemolysis and methaemoglobinaemia in G6PD deficiency, anaphylaxis and interference with uric acid assays (samples must be chilled) carry boxed warnings.
Backbone ribbon from PDB 1R51. RCSB PDB 1R51. The ribbon widens where the chain is folded into a regular pattern and narrows where it is a loose loop.
Recombinant Aspergillus urate oxidase that converts uric acid to allantoin, which is five to ten times more soluble and readily excreted, lowering plasma uric acid within hours.
1.Rasburicase binds its target.
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| Region | Year | Indication |
|---|---|---|
| US | 2002 | Initial management of plasma uric acid in paediatric patients with leukaemia, lymphoma or solid tumours at risk of tumour lysis (adults added 2009) |
| EU | 2001 | Treatment and prophylaxis of acute hyperuricaemia in haematological malignancy with high tumour burden (Fasturtec) |
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Query for this drug: (TITLE:"Rasburicase" OR ABSTRACT:"Rasburicase" OR TITLE:"Elitek" OR ABSTRACT:"Elitek" OR TITLE:"Fasturtec" OR ABSTRACT:"Fasturtec" OR TITLE:"Recombinant urate oxidase" OR ABSTRACT:"Recombinant urate oxidase") AND (cancer OR tumor OR tumour OR oncology OR carcinoma OR lymphoma OR leukemia OR leukaemia OR myeloma OR sarcoma OR melanoma OR glioma). Results are unfiltered search hits about Rasburicase, not a curated reading list.
Shares Sanofi, Acute lymphoblastic leukaemia, Acute myeloid leukaemia and the tag supportive.
Shares Sanofi, Diffuse large B-cell lymphoma and the tag supportive.
Shares Sanofi and the tag supportive.
Shares Burkitt lymphoma, Diffuse large B-cell lymphoma, Non-Hodgkin lymphoma (all types) and the tag supportive.
Shares Diffuse large B-cell lymphoma, Non-Hodgkin lymphoma (all types) and the tag supportive.
Shares Acute myeloid leukaemia and the tag supportive.
Shares Acute lymphoblastic leukaemia, Acute myeloid leukaemia and the tag supportive.
Shares Rituximab, Rasburicase, and Combination Chemotherapy in Treating Young Patients With Newly Diagnosed Advanced B-Cell Leukemia or Lymphoma and the tag supportive.