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Febuxostat better than allopurinol for preventing tumor lysis syndrome


 

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Febuxostat achieved significantly better serum uric acid control, compared with allopurinol, important for the prevention of tumor lysis syndrome (TLS), reported Dr. Michele Spina and coauthors from the division of medical oncology at the National Cancer Institute in Aviano, Italy.

Serum uric acid control is of key relevance in tumor lysis syndrome prevention as it correlates with both tumor lysis syndrome (TLS) and renal events risk, the investigators said.

In a randomized trial of 346 patients with hematologic malignancies and intermediate to high TLS risk, patients were given either a fixed dose of 120 mg of febuxostat or a dose of allopurinol at either 200, 300, or 600 mg. Febuxostat performed significantly better than allopurinol in reducing serum uric acid (P less than .0001). Both drugs achieved similar renal function preservation (P = .0903) and drug-related adverse events were reported in 6.4% of patients in both treatment arms.

The study is the “largest adult trial performed in TLS prevention,” Dr. Spina and her colleagues said in the paper. “Febuxostat achieved a significant superior serum uric acid control with one fixed dose in comparison to allopurinol with comparable renal function preservation and safety profile,” they concluded.

Read the full report in Annals of Oncology here.

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