The Medical Letter on Drugs and Therapeutics
Pegloticase (Krystexxa) for Treatment of Refractory Gout
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Pegloticase (Krystexxa – Savient), a PEGylated urate oxidase enzyme, has been approved by the FDA for intravenous (IV) treatment of chronic symptomatic gout in adults who have not responded to maximum doses of a xanthine oxidase inhibitor, such as allopurinol (Zyloprim, and others). Pegloticase is the second new drug approved for gout in more than 40 years; a new xanthine oxidase inhibitor, febuxostat (Uloric), was approved in 2009.1

MECHANISM OF ACTION — Unlike the xanthine oxidase inhibitors, which decrease serum concentrations of uric acid by inhibiting its synthesis, pegloticase reduces serum uric acid by catalyzing oxidation of uric acid into allantoin, an inert water-soluble purine metabolite that is cleared by the kidney.

PHARMACOLOGY — A single infusion of pegloticase produces maximal suppression of plasma urate ... more      

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Title: Pegloticase (Krystexxa) for Treatment of Refractory Gout
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