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Expert Opinion on Pegloticase with Concomitant Immunomodulatory Therapy in the Treatment of Uncontrolled Gout to Improve Efficacy, Safety, and Durability of Response

期刊

CURRENT RHEUMATOLOGY REPORTS
卷 24, 期 1, 页码 12-19

出版社

SPRINGER
DOI: 10.1007/s11926-022-01055-9

关键词

Antidrug antibodies; Gout; Immunogenicity; Immunomodulation; Pegloticase

资金

  1. Horizon Therapeutics plc (Deerfield, IL)

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Gout is a systemic disease that greatly impairs patients' quality of life and functionality. Adding an immunomodulator to pegloticase therapy for patients with uncontrolled gout can substantially improve treatment outcomes.
Purpose of Review Gout is a systemic disease from which some patients develop numerous painful tophi that adversely affect quality of life and functionality. Some patients treated with oral urate-lowering therapy are unable to maintain serum urate levels below 6 mg/dL, and these patients, thus classified as having refractory or uncontrolled gout, often require therapy with pegloticase to reduce symptoms and tophaceous burden. The objective of this expert opinion review is to summarize the available evidence supporting the use of concomitant immunomodulators with pegloticase to prevent development of anti-drug antibodies (ADAs) when treating patients with uncontrolled gout. Recent Findings Emerging evidence suggests that adding an immunomodulator to pegloticase therapy can substantially increase response rates to double those observed in phase 3 randomized controlled trials. The combination of immunomodulation with pegloticase should be considered in routine clinical practice to improve durability of response, efficacy, and safety among patients with uncontrolled gout who otherwise have limited therapeutic options.

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