Pegloticase is a pegylated enzyme containing a recombinant form of mammalian uricase enzyme derived from a genetically modified strain of E. coli. Pegloticase lowers uric acid by promoting the oxidation of uric acid to allantoin, which is then renally excreted. Pegloticase was initially approved in the U.S. in 2010.
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Full Prescribing Information
Pegloticase is indicated for treatment of chronic gout in adult patients refractory to conventional therapy.
Glucose-6-phosphate dehydrogenase (G6PD) deficiency. Patients at higher risk for G6PD deficiency (e.g., patients of African or Mediterranean ancestry) should be screened before starting pegloticase.
Common side effects may include gout flares (77%), infusion reactions (26%), anti-pegloticase antibodies (92%), nausea, confusion, ecchymosis, nasopharyngitis, constipation, chest pain, anaphylaxis, vomiting.
The pegloticase admixture should only be administered by intravenous infusion over no less than 120 minutes via gravity feed, syringe-type pump, or infusion pump. Do not administer as an intravenous push or bolus.
If an infusion reaction occurs during the administration of pegloticase, the infusion may be slowed, or stopped and restarted at a slower rate, at the discretion of the attending health care professional. Since infusion reactions can occur after completion of infusion, observation of patients for approximately an hour post-infusion should be considered.
Updated February 2020 - ARP Practice Committee
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