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For U.S. Healthcare Professionals Only

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PATIENTS WITH NORMAL URIC ACID LEVELS MAY BE AT SIGNIFICANT RISK1

Relationship between uric acid level and development of TLS in patients with hematologic malignancies1*

Relationship between rising uric acid levels and incidence of TLS Relationship between rising uric acid levels and incidence of TLS

*Results from a retrospective analysis conducted to determine the relationship between uric acid levels and TLS in 1198 patients with a hematological malignancy who were admitted for inpatient chemotherapy.

Not all patients who are at risk for TLS have elevated uric acid levels before starting anticancer therapy2

Factors that put patients at increased risk of developing hyperuricemia and TLS include3-5:

  • Bulky disease
  • Elevated LDH
  • Lymph node involvement
  • Elevated creatinine levels
  • Bone marrow involvement
  • Elevated WBC count
  • Renal involvement or insufficiency

Certain anticancer agents have been associated with elevated uric acid or TLS6-20†

Ibrutinib Lenalidomide Bortezomib Carfilzomib
Brentuximab vedotin Ixazomib Cetuximab Doxorubicin HCl
Nilotinib Rituximab Dasatinib Omacetaxine
Pomalidomide Vincristine sulfate Thalidomide Bendamustine HCl
Imatinib Obinutuzumab Venetoclax Romidepsin
Ibrutinib
Brentuximab vedotin
Nilotinib
Pomalidomide
Imatinib
Lenalidomide
Ixazomib
Rituximab
Vincristine sulfate
Obinutuzumab
Bortezomib
Cetuximab
Dasatinib
Thalidomide
Venetoclax
Carfilzomib
Doxorubicin HCl
Omacetaxine
Bendamustine HCl
Romidepsin

LDH=lactate dehydrogenase; WBC=white blood cell.

This is not a comprehensive list of agents.

Components of the R-CHOP regimen.

IMPORTANT SAFETY INFORMATION

WARNING: HYPERSENSITIVITY REACTIONS, HEMOLYSIS, METHEMOGLOBINEMIA, AND INTERFERENCE WITH URIC ACID MEASUREMENTS

  • Hypersensitivity Reactions: ELITEK can cause serious and fatal hypersensitivity reactions including anaphylaxis. Immediately and permanently discontinue ELITEK in patients who experience a serious hypersensitivity reaction.
  • Hemolysis: Do not administer ELITEK to patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency. Immediately and permanently discontinue ELITEK in patients developing hemolysis. Screen patients at higher risk for G6PD deficiency (e.g., patients of African or Mediterranean ancestry) prior to starting ELITEK.
  • Methemoglobinemia: ELITEK can result in methemoglobinemia in some patients. Immediately and permanently discontinue ELITEK in patients developing methemoglobinemia.
  • Interference with Uric Acid Measurements: ELITEK enzymatically degrades uric acid in blood samples left at room temperature. Collect blood samples in prechilled tubes containing heparin and immediately immerse and maintain sample in an ice water bath. Assay plasma samples within 4 hours of collection.

CONTRAINDICATIONS
ELITEK is contraindicated in patients with a history of anaphylaxis or severe hypersensitivity to rasburicase or in patients with development of hemolytic reactions or methemoglobinemia with rasburicase. ELITEK is contraindicated in individuals deficient in glucose-6-phosphate dehydrogenase (G6PD).

ADVERSE REACTIONS
Most common adverse reactions (incidence ≥20%), when used concomitantly with anticancer therapy, are vomiting, nausea, fever, peripheral edema, anxiety, headache, abdominal pain, constipation, diarrhea, hypophosphatemia, pharyngolaryngeal pain, and increased alanine aminotransferase.

USE IN SPECIFIC POPULATIONS

  • Pregnancy: Consider the benefits and risks of ELITEK and possible risks to the fetus when prescribing ELITEK to a pregnant woman
  • Lactation: Because of the potential for serious adverse reactions in the breastfed child, advise patients that breastfeeding is not recommended during treatment with ELITEK and for 2 weeks after the last dose 

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