Description

Pegloticase is a pegylated uricase enzyme used for treating severe, treatment-refractory gout. It works by converting uric acid to allantoin, which is more soluble and easily excreted by the kidneys. Pegloticase is typically reserved for patients with chronic gout who have failed to respond to or cannot tolerate conventional urate-lowering therapies. The phase III GOUT 1 and GOUT 2 trials (Sundy et al., 2011) demonstrated that biweekly infusions of pegloticase significantly reduced serum urate levels and improved symptoms in patients with treatment-refractory gout. However, pegloticase can cause severe allergic reactions and loss of efficacy due to the development of anti-drug antibodies. Regular monitoring of serum urate levels before each infusion is crucial to identify patients who may be developing resistance. Despite its potential side effects, pegloticase remains an important option for patients with severe, refractory gout who have limited treatment alternatives.