Critical appraisal of the role of pegloticase in the management of gout

Hang-Korng Ea,1,2 Pascal Richette1,21H&ocirc;pital Lariboisi&egrave;re, Rheumatology Department, Paris, France; 2University of Paris Diderot, Sorbonne Paris Cit&eacute;, Paris, FranceAbstract: Gout is a debilitating disease secondary to chronic hyperuricemia, and the subseque...

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Autores principales:	Ea HK, Richette P
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2012
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/8e18795e73864186be5d03b70f4f19f6
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spelling	oai:doaj.org-article:8e18795e73864186be5d03b70f4f19f62021-12-02T04:44:16ZCritical appraisal of the role of pegloticase in the management of gout1179-156Xhttps://doaj.org/article/8e18795e73864186be5d03b70f4f19f62012-06-01T00:00:00Zhttp://www.dovepress.com/critical-appraisal-of-the-role-of-pegloticase-in-the-management-of-gou-a10234https://doaj.org/toc/1179-156XHang-Korng Ea,1,2 Pascal Richette1,21H&ocirc;pital Lariboisi&egrave;re, Rheumatology Department, Paris, France; 2University of Paris Diderot, Sorbonne Paris Cit&eacute;, Paris, FranceAbstract: Gout is a debilitating disease secondary to chronic hyperuricemia, and the subsequent deposition of monosodium urate crystals is responsible for acute flare, gout arthropathies, tophi and renal lithiasis. Uric acid is the end product of purine metabolism in humans because the gene encoding uricase was lost during hominoid evolution. Pegloticase is a recombinant mammalian uricase conjugated to polyethylene glycol that catalyzes the oxidation of uric acid into allantoin, a more soluble end product. The use of this drug as urate-lowering therapy is a new approach in treating severe gout refractory to conventional therapy with xanthine oxidase inhibitors and uricosuric agents. Intravenous pegloticase has potent and long-lasting urate-lowering capacity with rapid efficacy on tophi resolution. However, pegloticase treatment is associated with infusion-related reactions despite prevention therapy with high-dose corticosteroids. Exacerbation of pre-existing cardiovascular diseases is another concern. The mechanisms of these events are unknown. Caution with long-term use of pegloticase is warranted, especially for patients with cardiovascular diseases.Keywords: gout, urate-lowering therapy, pegloticase, uricase, urate oxidase, immunogenicityEa HKRichette PDove Medical PressarticleDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol 2012, Iss default, Pp 63-70 (2012)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 Ea HK Richette P Critical appraisal of the role of pegloticase in the management of gout
description	Hang-Korng Ea,1,2 Pascal Richette1,21H&ocirc;pital Lariboisi&egrave;re, Rheumatology Department, Paris, France; 2University of Paris Diderot, Sorbonne Paris Cit&eacute;, Paris, FranceAbstract: Gout is a debilitating disease secondary to chronic hyperuricemia, and the subsequent deposition of monosodium urate crystals is responsible for acute flare, gout arthropathies, tophi and renal lithiasis. Uric acid is the end product of purine metabolism in humans because the gene encoding uricase was lost during hominoid evolution. Pegloticase is a recombinant mammalian uricase conjugated to polyethylene glycol that catalyzes the oxidation of uric acid into allantoin, a more soluble end product. The use of this drug as urate-lowering therapy is a new approach in treating severe gout refractory to conventional therapy with xanthine oxidase inhibitors and uricosuric agents. Intravenous pegloticase has potent and long-lasting urate-lowering capacity with rapid efficacy on tophi resolution. However, pegloticase treatment is associated with infusion-related reactions despite prevention therapy with high-dose corticosteroids. Exacerbation of pre-existing cardiovascular diseases is another concern. The mechanisms of these events are unknown. Caution with long-term use of pegloticase is warranted, especially for patients with cardiovascular diseases.Keywords: gout, urate-lowering therapy, pegloticase, uricase, urate oxidase, immunogenicity
format	article
author	Ea HK Richette P
author_facet	Ea HK Richette P
author_sort	Ea HK
title	Critical appraisal of the role of pegloticase in the management of gout
title_short	Critical appraisal of the role of pegloticase in the management of gout
title_full	Critical appraisal of the role of pegloticase in the management of gout
title_fullStr	Critical appraisal of the role of pegloticase in the management of gout
title_full_unstemmed	Critical appraisal of the role of pegloticase in the management of gout
title_sort	critical appraisal of the role of pegloticase in the management of gout
publisher	Dove Medical Press
publishDate	2012
url	https://doaj.org/article/8e18795e73864186be5d03b70f4f19f6
work_keys_str_mv	AT eahk criticalappraisaloftheroleofpegloticaseinthemanagementofgout AT richettep criticalappraisaloftheroleofpegloticaseinthemanagementofgout
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Critical appraisal of the role of pegloticase in the management of gout

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