Role of Hypouricemic Agents in Tumor Lysis Syndrome: A Meta-Analysis
Waleed Alshehri *
Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia.
Abdulrahman Aljohani
College of Medicine, Taibah University, Madinah, Saudi Arabia.
Reem Alhasani
College of Medicine, Umm Al Qura University, Al-Qunfudah, Saudi Arabia.
Anood Alshammari
Pharmacy Department, Northern Area Armed Forces Hospital, Hafar Al Batin, Saudi Arabia.
Jwael A. Alhamoud
College of Pharmacy, Batterjee Medical College, Jeddah, Saudi Arabia.
Atheer Alruwaili
Al-Dawaa Medical Services Co. LTD, Hafar Al Batin, Saudi Arabia.
Omniah Altemani
Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia.
Ali Bahabri
Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
Hassan Alahmadi
College of Medicine, Taibah University, Madinah, Saudi Arabia.
Shaykhah Alderaan
Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia.
Afnan Almutairi
Faculty of Medicine, Tabuk University, Tabuk, Saudi Arabia.
Marwan Alsehli
College of Medicine, Taibah University, Madinah, Saudi Arabia.
Mohammed Almohammadi
College of Medicine, Taibah University, Madinah, Saudi Arabia.
Faisal Almaleki
College of Medicine, Taibah University, Madinah, Saudi Arabia.
Hamoud Alotaibi
Department of Pharmacy, King Fahad Armed Forces Hospital, Jeddah, Saudi Arabia.
*Author to whom correspondence should be addressed.
Abstract
Objective and background: Tumor lysis syndrome (TLS) is a life-threatening emergency and demands emergency care of effective outcome with minimal or no side effects. The Hypouricemic agents, including Rasburicase, Allopurinol and Febuxostate used for the management of TLS. This study was designed to evaluate the Role of Hypouricemic agents by analyzing TLS development rate, control of uric acid, and Creatinine levels.
Methods: An extensive electronic data search was conducted by using all leading scientific databases. Twenty-six studies were selected to conduct this study, as per the inclusion criteria.
Results: The Odd ratio of TLS development rate was 4.06, 1.24, and 1.49 by Rusbricase, Allopurinol & Febuxostate administration respectively. 95% confidence interval was reported by selected studies against TLS development rate, Uric acid, and Creatinine levels by administrating Rusbricase, Allopurinol & Febuxostate.
Conclusion: All Hypouricemic agents, including Rasburicase, Allopurinol and Febuxostate, are effective to manage Tumor lysis Syndrome. However, a suitable and most effective intervention dose needs to identify with better efficacy and minimal side effects both in Adults and Children.
Keywords: Tumor lysis Syndrome (TLS), hypouricemic agents, rusbricase, allopurinol, febuxostate