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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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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 March 2018 - ARP Practice Committee
The information contained in this biologic reference guide is offered solely for purposes of providing health care professionals with a quick and initial reference. Before prescribing or administering any drug contained in this biologic reference guide, health professionals should read the manufacturer’s complete prescribing information in order to be informed of the various clinical considerations to be taken into account. The American College of Rheumatology is providing this information as a benefit and service in furtherance of its educational mission. By providing this information, ACR is not endorsing or recommending any of the listed companies or any of their drugs or other products. The information contained in the biologic reference guides reflect the conclusions of the individual companies and not those of the ACR which specifically disclaims any responsibility or liability for the use of such information and/or for the performance of any of the drugs listed in this biologic reference guide.