Recombinant urate oxidase
The enzyme humans lost — reinstalled for tumor lysis
- Converts uric acid to soluble allantoin
- Rapidly clears the urate load of tumor lysis syndrome
- Hemolysis in G6PD deficiency
- Falsely lowers uric acid in the collection tube
- Humans lack urate oxidase; uric acid is our dead end. The enzyme converts it to allantoin — 5-10× more soluble
- Destroys EXISTING urate (allopurinol only stops new production)
- ➔ rasburicase (ELITEK) — tumor lysis syndrome prevention/treatment
- ⚠ BOXED: G6PD deficiency → hemolysis/methemoglobinemia; anaphylaxis; blood urate samples must go on ice (ex-vivo degradation falsely lowers levels)
Drugs with this mechanism (1)
- Rasburicase — Urate oxidase that rapidly removes existing uric acid in tumor lysis; contraindicated in G6PD deficiency.
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