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Hyperuricemia/Gout

  • MORTALITY
  • CARDIOVASCULAR DISEASE
  • METABOLIC SYNDROME

Uric acid crystal Uric acid crystal Uric acid crystal

MORTALITY

The risk of death tripled in patients with gout and visible tophi at diagnosis3*

All-cause mortality increased by 9% with every 1-mg/dL increase in sUA level4†

*Among patients with gout for less than 10 years with tophi at baseline (based on a 5-year observational study of 295 adults).3

†Based on a meta-analysis of 14 studies involving 341,389 adults.4

sUA, serum uric acid.

Graphic showing gout and heart disease link Graphic showing gout and heart disease link Graphic showing gout and heart disease link

CARDIOVASCULAR DISEASE

Patients with high sUA levels saw a ~2x greater risk of cardiovascular mortality5*

Gout has been shown to be an independent risk factor for heart failure, hypertension, CHD, PAD, PVD, and stroke2,6

*Cardiovascular mortality, RR 2.09 (95% CI, 1.45-3.02); all-cause mortality, RR 1.80 (95% CI, 1.39-2.34) after adjustment for potential confounders in a random-effects model.5

CHD, coronary heart disease; PAD, peripheral arterial disease; PVD, peripheral vascular disease; RR, relative risk.

Neutrophil NETosis and DNA extrusion graphic Neutrophil NETosis and DNA extrusion graphic Neutrophil NETosis and DNA extrusion graphic

METABOLIC SYNDROME

Studies show gout is a risk factor for developing type 2 diabetes and is associated with metabolic syndrome2,7

As sUA levels increase, so does the prevalence of metabolic syndrome, and the sUA levels are positively associated with the development of type 2 diabetes.8

sUA, serum uric acid level.

Need more data?

The KRYSTEXXA team is available to share more information about elevated uric acid and comorbidities.

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sUA and tophus resolution

The lower the sUA level, the faster the urate burden can resolve.9-15

See the Data

Learn more about patients who might benefit from KRYSTEXXA

Actor portrayal of gout and CKD Stage 3b patient, David Actor portrayal of gout and CKD Stage 3b patient, David Actor portrayal of gout and CKD Stage 3b patient, David

David, CKD stage 3b

Occupation:
College professor

57-year-old with CKD stage 3b due to type 2 diabetes, diagnosed with gout 8 years ago

Learn About David

Actor portrayal, not actual patient.

Actor portrayal of gout and CKD Stage 4 patient, Lisa Actor portrayal of gout and CKD Stage 4 patient, Lisa Actor portrayal of gout and CKD Stage 4 patient, Lisa

Lisa, CKD stage 4

Occupation:
Office manager

58-year-old with CKD stage 4 due to ADPKD, diagnosed with gout 7 years ago

Learn About Lisa

Actor portrayal, not actual patient.

ADPKD, autosomal dominant polycystic kidney disease.

Actor portrayal of gout and kidney transplant patient, Harold Actor portrayal of gout and kidney transplant patient, Harold Actor portrayal of gout and kidney transplant patient, Harold

Harold, transplant patient

Occupation:
Journalist

64-year-old with type 2 diabetes, hypertension, and end-stage renal disease

Learn About Harold

Actor portrayal, not actual patient.

IMPORTANT SAFETY INFORMATION

WARNING: ANAPHYLAXIS AND INFUSION REACTIONS, G6PD DEFICIENCY ASSOCIATED HEMOLYSIS AND METHEMOGLOBINEMIA

  • Anaphylaxis and infusion reactions have been reported to occur during and after administration of KRYSTEXXA.
  • Anaphylaxis may occur with any infusion, including a first infusion, and generally manifests within 2 hours of the infusion. Delayed hypersensitivity reactions have also been reported.
  • KRYSTEXXA should be administered in healthcare settings and by healthcare providers prepared to manage anaphylaxis and infusion reactions.
  • Premedicate with antihistamines and corticosteroids and closely monitor for anaphylaxis for an appropriate period after administration of KRYSTEXXA.
  • Monitor serum uric acid levels prior to each infusion and discontinue treatment if levels increase to above 6 mg/dL, particularly when 2 consecutive levels above 6 mg/dL are observed.
  • Screen patients at risk for glucose-6-phosphate dehydrogenase (G6PD) deficiency prior to starting KRYSTEXXA. Hemolysis and methemoglobinemia have been reported with KRYSTEXXA in patients with G6PD deficiency. KRYSTEXXA is contraindicated in patients with G6PD deficiency.

CONTRAINDICATIONS:

  • In patients with G6PD deficiency.
  • In patients with history of serious hypersensitivity reactions, including anaphylaxis, to KRYSTEXXA or any of its components.

WARNINGS AND PRECAUTIONS

Gout Flares: An increase in gout flares is frequently observed upon initiation of anti-hyperuricemic therapy, including KRYSTEXXA. Gout flare prophylaxis with a non-steroidal anti-inflammatory drug (NSAID) or colchicine is recommended starting at least 1 week before initiation of KRYSTEXXA therapy and lasting at least 6 months, unless medically contraindicated or not tolerated.

Congestive Heart Failure: KRYSTEXXA has not been formally studied in patients with congestive heart failure, but some patients in the pre-marketing placebo-controlled clinical trials experienced exacerbation. Exercise caution in patients who have congestive heart failure and monitor patients closely following infusion.

ADVERSE REACTIONS

The most commonly reported adverse reactions (≥5%) are:

KRYSTEXXA co-administration with methotrexate trial:

KRYSTEXXA with methotrexate: gout flares, arthralgia, COVID-19, nausea, and fatigue; KRYSTEXXA alone: gout flares, arthralgia, COVID-19, nausea, fatigue, infusion reaction, pain in extremity, hypertension, and vomiting.

KRYSTEXXA pre-marketing placebo-controlled trials:

gout flares, infusion reactions, nausea, contusion or ecchymosis, nasopharyngitis, constipation, chest pain, anaphylaxis, and vomiting.

INDICATION

KRYSTEXXA® (pegloticase) is indicated for the treatment of chronic gout in adult patients who have failed to normalize serum uric acid and whose signs and symptoms are inadequately controlled with xanthine oxidase inhibitors at the maximum medically appropriate dose or for whom these drugs are contraindicated.

Limitations of Use: KRYSTEXXA is not recommended for the treatment of asymptomatic hyperuricemia.

Please see Full Prescribing Information, including Boxed Warning.

IMPORTANT SAFETY INFORMATION

WARNING: ANAPHYLAXIS AND INFUSION REACTIONS, G6PD DEFICIENCY ASSOCIATED HEMOLYSIS AND METHEMOGLOBINEMIA

  • Anaphylaxis and infusion reactions have been reported to occur during and after administration of KRYSTEXXA.
  • Anaphylaxis may occur with any infusion, including a first infusion, and generally manifests within 2 hours of the infusion. Delayed hypersensitivity reactions have also been reported.
  • KRYSTEXXA should be administered in healthcare settings and by healthcare providers prepared to manage anaphylaxis and infusion reactions.
  • Premedicate with antihistamines and corticosteroids and closely monitor for anaphylaxis for an appropriate period after administration of KRYSTEXXA.
  • Monitor serum uric acid levels prior to each infusion and discontinue treatment if levels increase to above 6 mg/dL, particularly when 2 consecutive levels above 6 mg/dL are observed.
  • Screen patients at risk for glucose-6-phosphate dehydrogenase (G6PD) deficiency prior to starting KRYSTEXXA. Hemolysis and methemoglobinemia have been reported with KRYSTEXXA in patients with G6PD deficiency. KRYSTEXXA is contraindicated in patients with G6PD deficiency.

CONTRAINDICATIONS:

  • In patients with G6PD deficiency.
  • In patients with history of serious hypersensitivity reactions, including anaphylaxis, to KRYSTEXXA or any of its components.

WARNINGS AND PRECAUTIONS

Gout Flares: An increase in gout flares is frequently observed upon initiation of anti-hyperuricemic therapy, including KRYSTEXXA. Gout flare prophylaxis with a non-steroidal anti-inflammatory drug (NSAID) or colchicine is recommended starting at least 1 week before initiation of KRYSTEXXA therapy and lasting at least 6 months, unless medically contraindicated or not tolerated.

Congestive Heart Failure: KRYSTEXXA has not been formally studied in patients with congestive heart failure, but some patients in the pre-marketing placebo-controlled clinical trials experienced exacerbation. Exercise caution in patients who have congestive heart failure and monitor patients closely following infusion.

ADVERSE REACTIONS

The most commonly reported adverse reactions (≥5%) are:

KRYSTEXXA co-administration with methotrexate trial:

KRYSTEXXA with methotrexate: gout flares, arthralgia, COVID-19, nausea, and fatigue; KRYSTEXXA alone: gout flares, arthralgia, COVID-19, nausea, fatigue, infusion reaction, pain in extremity, hypertension, and vomiting.

KRYSTEXXA pre-marketing placebo-controlled trials:

gout flares, infusion reactions, nausea, contusion or ecchymosis, nasopharyngitis, constipation, chest pain, anaphylaxis, and vomiting.

INDICATION

KRYSTEXXA® (pegloticase) is indicated for the treatment of chronic gout in adult patients who have failed to normalize serum uric acid and whose signs and symptoms are inadequately controlled with xanthine oxidase inhibitors at the maximum medically appropriate dose or for whom these drugs are contraindicated.

Limitations of Use: KRYSTEXXA is not recommended for the treatment of asymptomatic hyperuricemia.

Please see Full Prescribing Information, including Boxed Warning.

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  • Maiuolo J, et al. Int J Cardiol. 2016;213:8-14.
  • Vargas-Santos AB, et al. Am J Kidney Dis. 2017;70(3):422-439.
  • Doghramji PP, et al. Postgrad Med. 2012;124(6):98-109.