Learn about:

  • MICHELLE
  • ANDREW

Meet Michelle, a patient you may see in your practice

Actor portrayal of patient with no visible tophi

Patient name/age:

Michelle, 59

Occupation:

Nurse

Actor portrayal, not actual patient.
Patient history icon

Patient History

  • Diagnosed with gout 5 years ago by a primary care physician, referred to a rheumatologist last year
  • Flares: 4 in the last year
    • 2 resulted in emergency room visits
  • Tophi: no visible tophi
  • Comorbidities: diabetes

KRYSTEXXA is not indicated for the treatment of pain.
A1C, glycated hemoglobin, BMI, body mass index; G6PD, glucose-6-phosphate dehydrogenase; QD, every day; sUA, serum uric acid.

Laboratory Workup

sUA level:

7.3 mg/dL

BMI:

28

G6PD:

normal

A1C:

7.2%

Renal function:

normal

Treatment history icon Current Treatment

Allopurinol:

800 mg QD (for the past year)

Metformin:

850 mg QD

Linagliptin:

5 mg QD

Flare Medication

Colchicine:

0.6 mg QD for prophylaxis

Patient Background
  • While Michelle doesn't have any visible tophi, she does have pain and tenderness in her hands, which has affected her job as a nurse and at home, making it difficult to help her daughter with her newborn
  • Michelle's father dealt with unspecified arthritis, with similar symptoms to hers
  • At 59, her flares are quite painful, but her own online research led her to the conclusion that flares are completely based on diet, ie, her own fault

KRYSTEXXA is not indicated for the treatment of pain.
A1C, glycated hemoglobin; BMI, body mass index; G6PD, glucose-6-phosphate dehydrogenase; QD, every day; sUA, serum uric acid.

Meet Andrew, a patient you may see in your practice

Actor portrayal of patient with pain who was diagnosed with gout years ago

Patient name/age:

Andrew, 56

Occupation:

Real estate agent

Actor portrayal, not actual patient.
Patient history icon

Patient History

  • Diagnosed with gout 8 years ago
  • Flares: 4 in the last year
    • 2 resulted in urgent care visits
    • 2 mitigated with flare prophylaxis
  • Pain: complaining of pain in his hands and feet
  • Tophi: pea-sized tophus on his right hand for the past 2 years; golf ball–sized tophus on left ankle; both nonresolving
  • Comorbidities: hypertension

KRYSTEXXA is not indicated for the treatment of pain.
BMI, body mass index; BP, blood pressure; G6PD, glucose-6-phosphate dehydrogenase; QD, every day; sUA, serum uric acid.

Laboratory Workup

sUA level:

8.4 mg/dL

BMI:

31

G6PD:

normal

BP:

128/80

Renal function:

normal

Treatment history icon Current Treatment

Allopurinol:

600 mg QD (for the past year)

Losartan:

50 mg QD

Flare Medication

Colchicine:

0.6 mg QD for prophylaxis

Prednisone:

40 mg QD for active flares

Patient Background
  • When Andrew greets clients, he extends his left hand to shake so they avoid seeing the tophus
  • Increased discomfort and pain due to flares have caused Andrew to remain home more often, sometimes leading to a loss of potential real estate clients. The resulting financial burden is causing him stress and anxiety

KRYSTEXXA is not indicated for the treatment of pain.
BMI, body mass index; BP, blood pressure; G6PD, glucose-6-phosphate dehydrogenase; QD, every day; sUA, serum uric acid.

Before & After KRYSTEXXA with methotrexate

Real KRYSTEXXA patient, Bet

REAL PATIENT

Patient name/age:

Occupation:

Stay-at-home parent

The ACR Guidelines STRONGLY RECOMMEND pegloticase for patients like Bet1

KRYSTEXXA can be coadministered with methotrexate2

Patient history icon

Patient History

  • A father and husband who loves spending time with his children
  • Has had gout for over 20 years
  • Stopped working construction due to pain and limited mobility
  • No known comorbidities

Physical & Lab Evaluation

Before

  • sUA level: >6 mg/dL
  • BMI: 38.5
  • Swollen/tender joints: Chronic pain in multiple joints
  • Tophi: Visible tophi
  • Flares: >2/year

After

  • sUA level: <1 mg/dL
  • Tophi: Reduced
  • Functional Status: Can walk and perform daily activities

Treatment History

Before

  • Allopurinol: 7 years with increasing doses
  • Colchicine: 7 years while flaring
  • Febuxostat: 1 year

Picture of tophi in handBEFORE

Enlarge

After

  • Colchicine: 0.6 mg as needed
  • KRYSTEXXA: 8 mg every 2 weeks
  • Methotrexate: 15 mg orally per week

Picture of hand after treatmentAFTER

Enlarge

Best results seen at 6-12 months.2 Optimal treatment duration has not been established.2 Individual results may vary.

Best results seen at 6-12 months.2 Optimal treatment duration has not been established.2 Individual results may vary.

“I wish I had started KRYSTEXXA (with methotrexate) sooner. Now, I go out and do things and not just want to stay at home. I’m definitely in a better place now.”

INDICATION
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.
KRYSTEXXA is not indicated for the treatment of pain.
ACR, American College of Rheumatology; BMI, body mass index; sUA, serum uric acid.

Evaluate Your Gout Patients Using “STOP”1

Click any card to learn more about STOP

Evaluate Your Gout Patients Using “STOP”2

Click any card to learn more about STOP

Hand Icon sUA >6 Is their uric acid level >6 mg/dL? Hand Icon TOPHI Do they have nonresolving tophi? Hand Icon ORAL ULT FAILURE Have they been taking the maximum medically appropriate dose of ULTs? Hand Icon PAINFUL FLARES Have they had 2 or more painful flares in the past year?

Uncontrolled gout is not defined by having all the criteria above. KRYSTEXXA is not indicated for the treatment of pain.

sUA, serum uric acid; ULT, urate-lowering therapy.

Uncontrolled gout is not defined by having all the criteria above. KRYSTEXXA is not indicated for the treatment of pain.

ULT, urate-lowering therapy.

Have a patient who might
be ready for KRYSTEXXA?

Connect with the KRYSTEXXA team to discuss the ACR Guidelines and treatment criteria.

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IMPORTANT SAFETY INFORMATION

WARNING: ANAPHYLAXIS AND INFUSION REACTIONS, G6PD DEFICIENCY ASSOCIATED HEMOLYSIS AND METHEMOGLOBINEMIA

  • Anaphylaxis and infusion reactions have been reported to occur during and after administration of KRYSTEXXA.
  • Anaphylaxis may occur with any infusion, including a first infusion, and generally manifests within 2 hours of the infusion. Delayed hypersensitivity reactions have also been reported.
  • KRYSTEXXA should be administered in healthcare settings and by healthcare providers prepared to manage anaphylaxis and infusion reactions.
  • Premedicate with antihistamines and corticosteroids and closely monitor for anaphylaxis for an appropriate period after administration of KRYSTEXXA.
  • Monitor serum uric acid levels prior to each infusion and discontinue treatment if levels increase to above 6 mg/dL, particularly when 2 consecutive levels above 6 mg/dL are observed.
  • Screen patients at risk for glucose-6-phosphate dehydrogenase (G6PD) deficiency prior to starting KRYSTEXXA. Hemolysis and methemoglobinemia have been reported with KRYSTEXXA in patients with G6PD deficiency. KRYSTEXXA is contraindicated in patients with G6PD deficiency.

CONTRAINDICATIONS:

  • In patients with G6PD deficiency.
  • In patients with history of serious hypersensitivity reactions, including anaphylaxis, to KRYSTEXXA or any of its components.

WARNINGS AND PRECAUTIONS

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.

ADVERSE REACTIONS

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.

INDICATION

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.

IMPORTANT SAFETY INFORMATION

WARNING: ANAPHYLAXIS AND INFUSION REACTIONS, G6PD DEFICIENCY ASSOCIATED HEMOLYSIS AND METHEMOGLOBINEMIA

  • Anaphylaxis and infusion reactions have been reported to occur during and after administration of KRYSTEXXA.
  • Anaphylaxis may occur with any infusion, including a first infusion, and generally manifests within 2 hours of the infusion. Delayed hypersensitivity reactions have also been reported.
  • KRYSTEXXA should be administered in healthcare settings and by healthcare providers prepared to manage anaphylaxis and infusion reactions.
  • Premedicate with antihistamines and corticosteroids and closely monitor for anaphylaxis for an appropriate period after administration of KRYSTEXXA.
  • Monitor serum uric acid levels prior to each infusion and discontinue treatment if levels increase to above 6 mg/dL, particularly when 2 consecutive levels above 6 mg/dL are observed.
  • Screen patients at risk for glucose-6-phosphate dehydrogenase (G6PD) deficiency prior to starting KRYSTEXXA. Hemolysis and methemoglobinemia have been reported with KRYSTEXXA in patients with G6PD deficiency. KRYSTEXXA is contraindicated in patients with G6PD deficiency.

CONTRAINDICATIONS:

  • In patients with G6PD deficiency.
  • In patients with history of serious hypersensitivity reactions, including anaphylaxis, to KRYSTEXXA or any of its components.

WARNINGS AND PRECAUTIONS

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.

ADVERSE REACTIONS

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.

INDICATION

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.

  • FitzGerald JD, et al. Arthritis Care Res (Hoboken). 2020;72:744-760.
  • KRYSTEXXA (pegloticase) [prescribing information] Horizon.