Gout is an inflammatory
arthritis characterized by sudden, painful
inflammation.
Gout can affect any joint in an asymmetric distribution. Gouty attacks may be isolated or can be followed by years of recurrent flares. Over time, elevated serum
urate levels and tophaceous deposits can lead to
deformity and disability from underlying bony erosion. The concept of 'treatment-failure
gout' describes a unique population that has been either unable to tolerate
allopurinol or who have not experienced normalization of serum
urate levels on
allopurinol. It is estimated that approximately 1-1.5% of the estimated 3-8 million people with
gout in the USA have treatment-failure
gout.
Pegloticase is an US FDA-approved intravenous medication that is a mammalian recombinant
uricase conjugated to monomethoxy
polyethylene glycol. Two recent Phase III trials have found
pegloticase to be effective in the management of treatment-failure
gout. These studies also highlight safety concerns regarding the
drug's immunogenicity.