{Reference Type}: Journal Article
{Title}: A retrospective review of rasburicase utilization in pediatric and adult patients across a large health system.
{Author}: Kamel A;Sanders M;Dyk H;Hamilton T;
{Journal}: J Oncol Pharm Pract
{Volume}: 0
{Issue}: 0
{Year}: 2024 May 25
{Factor}: 1.416
{DOI}: 10.1177/10781552241253214
{Abstract}: <B>OBJECTIVE: </B>This study aimed to characterize rasburicase dosing and duration. Secondary objectives included characterizing the indication of rasburicase and identifying the utilization of prophylactic therapy for tumor lysis syndrome (TLS).<BR><B>METHODS: </B>This retrospective review included patients 0 to 89 years old admitted between 1 January 2021 and 31 December 2021, and received at least one dose of rasburicase. Patients were excluded if they were >89 years old, pregnant, lactating, or received rasburicase outpatient.<BR><B>RESULTS: </B>A total of 192 patients, 176 adults and 16 pediatric patients were included in the retrospective review. Of the total population, 184 received a fixed dose of rasburicase and 8 patients received a weight-based dose (0.15 mg/kg/dose) of rasburicase. The average dose administered was 3.4 mg for fixed and 2.99 mg for weight-based dosing. Nearly half (49.5%) the patients received rasburicase for an elevated uric acid but did not meet Cairo-Bishop criteria for TLS. Only 42.2% received at least one dose of allopurinol within 5 days prior to rasburicase and 18.8% received aggressive hydration within 72 h prior to rasburicase.<BR><B>CONCLUSIONS: </B>The majority of rasburicase administered was ordered as fixed dose for a uric acid level ≥7.5 mg/dL. Most patients did not meet criteria for laboratory or clinical TLS and less than half the patients received prophylactic allopurinol and/or aggressive hydration. These study results are supported by recent literature for fixed dose rasburicase as a safe and economical dosing strategy compared to weight-based dosing.