Introduction: Tumor lysis syndrome (TLS) is a therapy-related complication resulting from the rapid lysis of malignant cells post-treatment. The control of serum uric acid level plays a key role in its prevention, thus, allopurinol is used. Febuxostat is a novel xanthine oxidase inhibitor and there are currently no recommendations for using such in the prevention of TLS, hence, this study was conducted. This study aims to determine the efficacy of febuxostat in the prevention of TLS. Methods: Extensive search for randomized controlled trials (RCT) focusing on the use of febuxostat in the prevention of TLS was done. Each article was appraised independently by the researchers. The data were analysed using Rev Man 5.3. Results: Two trials were included in this review. The study results revealed that febuxostat, when compared to allopurinol, was able to decrease serum uric acid as hyperuricemia is the hallmark of TLS. This decrease in serum uric acid was consistent in both studies. Serum uric acid levels at the end of the treatment showed a standard mean difference of -1.09 (95% CI-1.29, -0.88, p for heterogeneity <0.01, p for effect <0.01, I2 = 97%). The trend of both studies favored the efficacy of febuxostat. The adverse effects documented during the study period in both trials were mostly noted from the chemotherapeutic agents and none from the use of febuxostat. Conclusion Febuxostat was shown to be more effective than allopurinol in the prevention of TLS.
Febuxostat ; Tumor Lysis Syndrome ; Meta-Analysis