sUA level:
6.9 mg/dL
G6PD:
normal
Albuminuria:
76 mg/g
eGFR:
26 mL/min/1.73 m2
BP:
127/79 mm Hg
Allopurinol:
100 mg QD
Atorvastatin:
10 mg QD
Losartan:
50 mg QD
Atenolol:
50 mg QD
Aspirin:
75 mg QD
Prednisone:
40 mg QD as needed
sUA level:
7.9 mg/dL
G6PD:
normal
Albuminuria:
200 mg/g
eGFR:
41 mL/min/1.73 m2
BP:
130/82 mm Hg
Allopurinol:
300 mg QD
Losartan:
50 mg QD
Metformin:
850 mg QD
Colchicine:
0.6 mg QD for prophylaxis
Prednisone:
40 mg QD for active flares
sUA level:
7.3 mg/dL
G6PD:
normal
Albuminuria:
100 mg/g
eGFR:
57 mL/min/1.73 m2
BP:
135/78 mm Hg
Allopurinol:
50 mg QD
Losartan:
50 mg QD
Metformin:
850 mg QD
Canagliflozin:
100 mg QD
Colchicine:
0.3 mg QD for prophylaxis
Prednisone:
40 mg QD for active flares
Antimetabolite
Calcineurin inhibitor
Low-dose steroid
Before |
---|
sUA level:10.3 mg/dL |
Tophi: Visible tophi |
Swollen, tender joints: Chronic pain in multiple joints |
Flares: 1-2/month |
After |
---|
sUA level: 1.5 mg/dL |
Tophi: 1 completely resolved, others reduced |
Functional Status: Can walk, perform most daily activities, and is back to planning trips with his family |
Before |
---|
Allopurinol: Discontinued due to side effects |
Colchicine: As needed during flares |
Uloric: Discontinued due to side effects |
After |
---|
Colchicine: As needed |
Methotrexate: 15 mg orally per week |
KRYSTEXXA: 8 mg every 2 weeks |
KRYSTEXXA® (pegloticase) is indicated for the treatment of chronic gout in adult patients who have failed to normalize serum uric acid and whose signs and symptoms are inadequately controlled with xanthine oxidase inhibitors at the maximum medically appropriate dose or for whom these drugs are contraindicated. Limitations of Use: KRYSTEXXA is not recommended for the treatment of asymptomatic hyperuricemia. sUA, serum uric acid.
ACR Guidelines strongly recommend pegloticase for your patients with uncontrolled gout.2*
How can reducing antidrug antibodies improve patient response?
Gout Flares: An increase in gout flares is frequently observed upon initiation of anti-hyperuricemic therapy, including KRYSTEXXA. Gout flare prophylaxis with a non-steroidal anti-inflammatory drug (NSAID) or colchicine is recommended starting at least 1 week before initiation of KRYSTEXXA therapy and lasting at least 6 months, unless medically contraindicated or not tolerated.
Congestive Heart Failure: KRYSTEXXA has not been formally studied in patients with congestive heart failure, but some patients in the pre-marketing placebo-controlled clinical trials experienced exacerbation. Exercise caution in patients who have congestive heart failure and monitor patients closely following infusion.
The most commonly reported adverse reactions (≥5%) are:
KRYSTEXXA co-administration with methotrexate trial:
KRYSTEXXA with methotrexate: gout flares, arthralgia, COVID-19, nausea, and fatigue; KRYSTEXXA alone: gout flares, arthralgia, COVID-19, nausea, fatigue, infusion reaction, pain in extremity, hypertension, and vomiting.
KRYSTEXXA pre-marketing placebo-controlled trials:
gout flares, infusion reactions, nausea, contusion or ecchymosis, nasopharyngitis, constipation, chest pain, anaphylaxis, and vomiting.
KRYSTEXXA® (pegloticase) is indicated for the treatment of chronic gout in adult patients who have failed to normalize serum uric acid and whose signs and symptoms are inadequately controlled with xanthine oxidase inhibitors at the maximum medically appropriate dose or for whom these drugs are contraindicated.
Limitations of Use: KRYSTEXXA is not recommended for the treatment of asymptomatic hyperuricemia.
Please see Full Prescribing Information, including Boxed Warning.