Pegloticase ‘effectively and expeditiously’ leads 47% of gout patients into remission
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Nearly half of patients with gout achieved remission with pegloticase treatment by 52 weeks, indicating longer-term benefits for intensive urate-lowering therapy, according to data presented at EULAR 2024 Congress.
“As the systemic consequences of gout become more apparent, the concept of treating gout to remission is increasingly important to improve patient care and preserve patient health,” study investigator Brian LaMoreaux, MD, a rheumatologist and executive medical director at Amgen, told Healio. “Many other diseases have well-defined definitions of remission, but gout has lagged behind on this.”
To examine how often intensive urate-lowering therapy led to gout remission according to previously proposed criteria, LaMoreaux and colleagues conducted a post hoc analysis of data from the MIRROR trial. This trial tested pegloticase (Krystexxa, Amgen) alongside methotrexate against placebo for the treatment of gout. Patients were classified as achieving remission if they met all of the following criteria over a 12-month period:
- serum urate level of 6 mg/dL or less;
- absence of acute gout flare;
- resolution of one or more tophus in those with tophi prior to treatment;
- minimal gout-related pain; and
- minimal gout-related quality of life impact.
The data included 145 patients treated with at least one 8 mg infusion of pegloticase, 74 of whom continued biweekly infusions through week 52.
According to the researchers, 18 of the 90 (20%) patients who continued through week 24, and 35 out of the 74 (47%) who continued through week 52, achieved gout remission. In each of the remission criteria, the proportion of patients achieving it grew from week 24 to 52, especially regarding the resolution of one or more tophus — 34% to 68% — and achieving a score of one or less on the Health Assessment Questionnaire Pain — 48% to 73%.
“This gout remission analysis provides further evidence on the overall efficacy of Krystexxa to effectively and expeditiously treat uncontrolled gout patients, but also that Krystexxa treatment longer than 6 months may provide accrued clinical beneficial to patients,” LaMoreaux said. “For clinicians, the data provide insight on how sustained, intensive serum urate lowering with Krystexxa, and subsequent urate depletion, can result in a marked reduction of gout signs and symptoms, and an improvement in patient quality of life.”
According to LaMoreaux, the results “illuminate several quality-of-life benefits” resulting from the intensive urate-lowering therapy.
“Prior MIRROR RCT data presentations have demonstrated that tophi improvement can occur at 6 months, but many more patients see improvement after 12 months of treatment with Krystexxa,” he said. “These data align with those findings and provide more insight on the overall benefits patients may receive when treated with Krystexxa for 6 months or longer.”
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Klionsky Y. POS0239. Presented at: EULAR 2024 Congress; June 12 to June 15, 2024, Vienna, Austria.
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