Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network Database
Abstract Introduction Pegloticase rapidly reduces serum urate (SU) in uncontrolled gout. This preliminary retrospective analysis of a large US rheumatology database examined post-pegloticase use and SU-lowering efficacy of oral urate-lowering therapy (ULT; allopurinol, febuxostat, probenecid). Metho...
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Adis, Springer Healthcare
2025-05-01
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| Series: | Rheumatology and Therapy |
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| Online Access: | https://doi.org/10.1007/s40744-025-00767-5 |
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| author | Lissa Padnick-Silver Andrew Concoff Hong-Ye Gao Qianhong Fu Brian LaMoreaux N. Lawrence Edwards |
| author_facet | Lissa Padnick-Silver Andrew Concoff Hong-Ye Gao Qianhong Fu Brian LaMoreaux N. Lawrence Edwards |
| author_sort | Lissa Padnick-Silver |
| collection | DOAJ |
| description | Abstract Introduction Pegloticase rapidly reduces serum urate (SU) in uncontrolled gout. This preliminary retrospective analysis of a large US rheumatology database examined post-pegloticase use and SU-lowering efficacy of oral urate-lowering therapy (ULT; allopurinol, febuxostat, probenecid). Methods Patients in the United Rheumatology (UR)-NICE data repository with first pegloticase code (J2507) in 2012–2022 and data for ≥ 60 days following last infusion were included. Post-pegloticase oral ULT efficacy was defined as SU < 6 mg/dL after oral ULT initiation and examined by shorter (< 12 infusions) and longer (≥ 12 infusions) pegloticase course and by time to post-pegloticase oral ULT start. Results A total of 211 patients (77.3% male; 62.7 ± 12.8 years, body mass index 32.9 ± 7.2 kg/m2, estimated glomerular filtration rate 66.0 ± 24.7 ml/min/1.73 m2) with gout [74.4% tophaceous, SU 7.9 ± 2.5 mg/dL (n = 148)] were included; 66.8% received pre-pegloticase oral ULT (48.8% allopurinol, 32.2% febuxostat, and/or 12.3% probenecid). Patients received 12.3 ± 12.6 pegloticase infusions [median 9; 88 (42%) ≥ 12 infusions; 2.3 ± 2.0 weeks between infusions], with 115 patients (54.5%) beginning oral ULT after pegloticase discontinuation (67.0% allopurinol, 43.5% febuxostat, and/or 16.5% probenecid) most-often (66.1%) ≤ 30 days of last infusion. More patients who received ≥ 12 infusions than < 12 infusions had SU < 6 mg/dL with post-pegloticase oral ULT use [first post-ULT SU < 6 mg/dL, 78.4% vs. 36.2%; SU 4.7 ± 3.0 (n = 37) vs. 7.4 ± 2.9 (n = 47) mg/dL]. Conclusions In this uncontrolled gout population, approximately two-thirds of patients began oral ULT within 30 days after their last pegloticase infusion. Those with longer pegloticase course more often had oral ULT efficacy, perhaps because of greater urate burden depletion, suggesting oral ULTs may be effective after successful pegloticase therapy. Further studies to understand any influence of urate burden on oral ULT efficacy are warranted. |
| format | Article |
| id | doaj-art-7672bf9559c44f71bd8005ea6363c539 |
| institution | Kabale University |
| issn | 2198-6576 2198-6584 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Adis, Springer Healthcare |
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| series | Rheumatology and Therapy |
| spelling | doaj-art-7672bf9559c44f71bd8005ea6363c5392025-08-20T04:03:11ZengAdis, Springer HealthcareRheumatology and Therapy2198-65762198-65842025-05-0112470971910.1007/s40744-025-00767-5Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network DatabaseLissa Padnick-Silver0Andrew Concoff1Hong-Ye Gao2Qianhong Fu3Brian LaMoreaux4N. Lawrence Edwards5Amgen, Inc.United RheumatologyAmgen, Inc.Amgen, Inc.Amgen, Inc.University of Florida College of MedicineAbstract Introduction Pegloticase rapidly reduces serum urate (SU) in uncontrolled gout. This preliminary retrospective analysis of a large US rheumatology database examined post-pegloticase use and SU-lowering efficacy of oral urate-lowering therapy (ULT; allopurinol, febuxostat, probenecid). Methods Patients in the United Rheumatology (UR)-NICE data repository with first pegloticase code (J2507) in 2012–2022 and data for ≥ 60 days following last infusion were included. Post-pegloticase oral ULT efficacy was defined as SU < 6 mg/dL after oral ULT initiation and examined by shorter (< 12 infusions) and longer (≥ 12 infusions) pegloticase course and by time to post-pegloticase oral ULT start. Results A total of 211 patients (77.3% male; 62.7 ± 12.8 years, body mass index 32.9 ± 7.2 kg/m2, estimated glomerular filtration rate 66.0 ± 24.7 ml/min/1.73 m2) with gout [74.4% tophaceous, SU 7.9 ± 2.5 mg/dL (n = 148)] were included; 66.8% received pre-pegloticase oral ULT (48.8% allopurinol, 32.2% febuxostat, and/or 12.3% probenecid). Patients received 12.3 ± 12.6 pegloticase infusions [median 9; 88 (42%) ≥ 12 infusions; 2.3 ± 2.0 weeks between infusions], with 115 patients (54.5%) beginning oral ULT after pegloticase discontinuation (67.0% allopurinol, 43.5% febuxostat, and/or 16.5% probenecid) most-often (66.1%) ≤ 30 days of last infusion. More patients who received ≥ 12 infusions than < 12 infusions had SU < 6 mg/dL with post-pegloticase oral ULT use [first post-ULT SU < 6 mg/dL, 78.4% vs. 36.2%; SU 4.7 ± 3.0 (n = 37) vs. 7.4 ± 2.9 (n = 47) mg/dL]. Conclusions In this uncontrolled gout population, approximately two-thirds of patients began oral ULT within 30 days after their last pegloticase infusion. Those with longer pegloticase course more often had oral ULT efficacy, perhaps because of greater urate burden depletion, suggesting oral ULTs may be effective after successful pegloticase therapy. Further studies to understand any influence of urate burden on oral ULT efficacy are warranted.https://doi.org/10.1007/s40744-025-00767-5PegloticaseOral urate-lowering therapyTreatment patternsEfficacy |
| spellingShingle | Lissa Padnick-Silver Andrew Concoff Hong-Ye Gao Qianhong Fu Brian LaMoreaux N. Lawrence Edwards Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network Database Rheumatology and Therapy Pegloticase Oral urate-lowering therapy Treatment patterns Efficacy |
| title | Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network Database |
| title_full | Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network Database |
| title_fullStr | Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network Database |
| title_full_unstemmed | Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network Database |
| title_short | Oral Urate-Lowering Therapy Use and Efficacy Following Pegloticase Treatment: Findings from a Rheumatology Network Database |
| title_sort | oral urate lowering therapy use and efficacy following pegloticase treatment findings from a rheumatology network database |
| topic | Pegloticase Oral urate-lowering therapy Treatment patterns Efficacy |
| url | https://doi.org/10.1007/s40744-025-00767-5 |
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