Due to the above-described properties, urate oxidase is used medicinally as "rasburicase" (trade name Fasturtec R® )(Herold 2021). Rasburicase is recommended in tumor lysis syndrome - despite the lack of studies - in first-line therapy (Kuhlmann 2015).
Indications:
- For prophylaxis of acute renal failurein aggressively growing lymphomas before or during chemotherapy (Kuhlmann 2015).
- Tumor lysis syndrome
Tumor lysis syndrome is a potentially life-threatening clinical picture that can develop spontaneously in fast-growing tumors or during therapy and results from rapid cell decay (apoptosis).
Laboratory chemical changes include:
- Hyperkalemia (25% of baseline or ≥ 6.0 mmol / l [Kuhlmann 2015]).
- Hyperuricemia (25 % of baseline or ≥ 8.0 mg / dl [Kuhlmann 2015])
- Hyperphosphatemia (25% of baseline or ≥ 1.45 mmol / l [Kuhlmann 2015])
- Secondary hypocalcaemia (25% decrease from baseline or ≤ 1.75 mmol / l [Kuhlmann 2015]).
Clinical symptoms include cardiac arrhythmias (due to hyperkalemia [Kuhlmann 2015]), convulsions, acute renal failure (Neuendorff 2020).
Side effects:
- allergic reactions to the ingredients
- Induction of antibodies to the ingredients (Herold 2021).
Contraindications:
- Allergies to the ingredients
- glucose- 6- phosphate- dehydrogenase deficiency
- Diseases that may also lead to hemolytic anemia (Aktories 2017).
Application: Rasburicase is injected i. v. only. The onset of action is relatively rapid and is a few hours. The duration of efficacy is 10 h (Herold 2021).
Dosage: Dosage recommendation 0.15 - 0.20 mg / kg bw i. v. in combination with i. v. hydration (Kuhlmann 2015).