2018 Volume 42 Issue 2 Pages 157-164
Tumor lysis syndrome (TLS) causes hyperuricemia in patients with malignancies under chemotherapeutic treatment. Lowering serum uric acid (S-UA) levels is the most important. Febuxostat has been officially used for chemotherapy-associated hyperuricemia since May 2016 in Japan. Rasburicase and febuxostat reduce S-UA. Rasburicase is effective for high-risk TLS, and febuxostat for low-intermediate risk. Here, febuxostat was evaluated as a treatment for cancer-related hyperuricemia after becoming officially employed for TLS (June 2016 - November 2017). Sixty milligram was taken by mouth. The first chemotherapeutic treatment was started within a day after the first 60 mg dosing. The primary endpoint was S-UA normalization (≤ 7 mg/dL) on day 7 of chemotherapy. Twenty-four patients were evaluated (median: 70 years, range: 52-89 years, 14 males/10 females). The baseline S-UA was 7.2±2.7 mg/dL (mean±SD), and S-UA on the 7th day of chemotherapy was 2.5± 1.3 mg/dL (P<0.0001, by paired t-test). All patients met the primary endpoint. In addition, the baseline creatinine was 1.1±0.6 mg/dL (mean±SD), and the value on the 7th day of chemotherapy was 0.8±0.3 mg/dL (P=0.031, by paired t-test). Developing TLS was not observed. Severe adverse reactions were not noted. Thus, 60-mg febuxostat was effective against cancer-associated hyperuricemia.
