title: Hypouricemic effect and safety of febuxostat used for prevention of tumor lysis syndrome.
abstract: OBJECTIVE
  We evaluated the efficacy and safety of febuxostat, a non-purine xanthine oxidase inhibitor, used for prevention of hyperuricemia associated with tumor lysis syndrome (TLS).
  
  
  METHODS
  Records of adult patients with newly diagnosed or relapsed hematologic malignancies who received febuxostat within 7 days before initiation of chemotherapy were retrieved retrospectively at a single institute. The changes in serum uric acid levels from before and 7 days after initiation of febuxostat were evaluated and compared with the historical control group of patients who received allopurinol. We also evaluated non-hematological adverse events during the study period.
  
  
  RESULTS
  A total of 78 patients' records were analyzed, 38 in the febuxostat group and 39 in the allopurinol group. There were no significant differences in the incidence of treatment failure, defined as development of clinical TLS or receiving rasburicase, between the febuxostat and allopurinol group (5.2% vs 5.1%, P>0.99). The mean serum uric acid levels were significantly decreased, compared to the baseline (5.6 ± 2.1 mg/dL), at 7 days after initiation of febuxostat (3.1 ± 1.5 mg/dL, last observation carried forward, P<0.001). There were no statistically significant differences in the percent change in the serum uric acid levels between the 40 mg/day febuxostat and the 300 mg/day allopurinol groups (P = 0.57). Grade 3-4 liver dysfunctions were observed in both the febuxostat and allopurinol groups, without significant differences in incidence between the two groups (2.6% vs 5.1%, P>0.99). Neither gout flare nor skin rash occurred in any patients.
  
  
  CONCLUSIONS
  Febuxostat is feasible for prevention of hyperuricemia associated with TLS.
authors.affiliation: Department of Hematology, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575 Japan.
authors.forename: Koichiro
authors.initials: K
authors.lastname: Maie
authors.affiliation: Department of Hematology, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575 Japan.
authors.forename: Yasuhisa
authors.initials: Y
authors.lastname: Yokoyama
authors.affiliation: Department of Hematology, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575 Japan.
authors.forename: Naoki
authors.initials: N
authors.lastname: Kurita
authors.affiliation: Department of Pharmaceutical Sciences, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575 Japan.
authors.forename: Hideto
authors.initials: H
authors.lastname: Minohara
authors.affiliation: Division for Health Service Promotion, University of Tokyo, 7-3-1 Hongo, Bunkyo-ku, Tokyo, 113-0033 Japan.
authors.forename: Shintaro
authors.initials: S
authors.lastname: Yanagimoto
authors.affiliation: Department of Hematology, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575 Japan.
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Hasegawa
authors.affiliation: Department of Pharmaceutical Sciences, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575 Japan.
authors.forename: Masato
authors.initials: M
authors.lastname: Homma
authors.affiliation: Department of Hematology, University of Tsukuba, 1-1-1, Tennodai, Tsukuba, Ibaraki, 305-8575 Japan.
authors.forename: Shigeru
authors.initials: S
authors.lastname: Chiba
keywords: Allopurinol; Cancer chemotherapy; Febuxostat; Hyperuricemia; Tumor lysis syndrome