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- Title
The value of fixed rasburicase dosing versus weight-based dosing in the treatment and prevention of tumor lysis syndrome.
- Authors
Boutin, Alyssa; Blackman, Alison; O'Sullivan, David M.; Forcello, Nicholas
- Abstract
Background Rasburicase is a recombinant urate oxidase enzyme used for the treatment and prevention of tumor lysis syndrome. Our objective was to assess the efficacy of indication-based, low-dose rasburicase administration compared to the Food and Drug Administration-approved weight-based dosing. Methods This was a retrospective cohort study utilizing data from a tertiary medical center including patients admitted from 2012 to 2016, who received at least one dose of rasburicase. The primary outcome was achieving a uric acid level less than 7.5 mg/dl after a single dose of rasburicase in the preprotocol (Food and Drug Administration-approved weight-based dosing) and postprotocol (indication-based, low-dose) groups. Secondary outcomes included the change in uric acid levels between the pre- and postprotocol groups, adherence to the new institutional protocol, need for repeat rasburicase doses, and a cost analysis. Results Sixty-four patients received at least one dose of rasburicase between 1 January 2012 and 1 December 2016. Twenty-seven (79.4%) doses in the preprotocol group and 28 (82.4%) doses in the postprotocol group successfully achieved a uric acid level less than 7.5 mg/dl after a single dose of rasburicase (p=1.000). The average total monthly cost of rasburicase was reduced by 59.9% after adoption of the new protocol. Conclusions Indication-based, low-dose rasburicase displayed significantly more value when compared to weight-based dosing as shown by achieving cost savings without compromising clinical efficacy.
- Subjects
ACADEMIC medical centers; BODY weight; COST control; DRUGS; DOSE-effect relationship in pharmacology; LONGITUDINAL method; MEDICAL care costs; OXIDOREDUCTASES; PATIENT compliance; PHARMACEUTICAL arithmetic; UNITED States. Food &; Drug Administration; URIC acid; TREATMENT effectiveness; RETROSPECTIVE studies; TUMOR lysis syndrome; TUMOR treatment
- Publication
Journal of Oncology Pharmacy Practice, 2019, Vol 25, Issue 3, p577
- ISSN
1078-1552
- Publication type
Article
- DOI
10.1177/1078155217752075