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Evaluate Your Gout Patients Using2
Graphic spelling out the word 'STOP,' with the letter 'O' represented as a stop sign with a hand in the center Graphic spelling out the word 'STOP,' with the letter 'O' represented as a stop sign with a hand in the center Graphic spelling out the word 'STOP,' with the letter 'O' represented as a stop sign with a hand in the center

KRYSTEXXA is not indicated for the treatment of pain.

Learn about:

  • MICHAEL
  • SUSAN
  • DAVID
  • LISA
  • HAROLD
Real KRYSTEXXA patient, Michael

Meet Michael

A real patient.
A real transformation.
  • Married with 4 children, architect for 35 years
  • 30-year history of gout; flares and tophi impacted his work and leisure activities
  • Referred to a nephrologist who started Michael on KRYSTEXXA with methotrexate
  • Reduction in flares and tophi, including complete resolution of marble-sized tophus on his right hand

sUA, serum uric acid.

sUA, serum uric acid.

Hear Michael’s Story

A picture of tophi in fingers of KRYSTEXXA patient, Michael, in January 2021 before treatment

January 2021
Before KRYSTEXXA
sUA 10.3 mg/dL

A picture of KRYSTEXXA patient, Michael's, fingers in April 2022, with visible improvement

April 2022
KRYSTEXXA with methotrexate sUA <1.5 mg/dLsUA <1.5 mg/dL

0:00 / 0:00

Individual results may vary.

Optimal treatment duration has not been established.

sUA, serum uric acid.

Hear Michael’s Story

A picture of tophi in fingers of KRYSTEXXA patient, Michael, in January 2021 before treatment

January 2021
Before KRYSTEXXA
sUA 10.3 mg/dL

A picture of KRYSTEXXA patient, Michael's, fingers in April 2022, with visible improvement

April 2022
KRYSTEXXA with
methotrexate
sUA <1.5 mg/dL

0:00 / 0:00

Individual results may vary.

Optimal treatment duration has not been established.

Meet Susan

A patient with uncontrolled gout you may see in your practice.

Occupation:

Dental hygienist

Patient history icon

Patient History

  • 45-year-old diagnosed with gout 3 years ago by a primary care physician
  • Flares: 3 flares in the last year, complaining of joint pain
  • CKD stage 3b
  • Tophi: 1 small tophus on her left hand for the past 2 years
  • Comorbidities: hypertension, diabetes

Actor portrayal, not actual patient.

Treatment history icon Laboratory Workup

sUA level:

7.9 mg/dL

G6PD:

normal

Albuminuria:

200 mg/g

eGFR:

41 mL/min/1.73 m2

BP:

130/82 mm Hg

Physical and lab evaluation icon Current Treatments

Allopurinol:

300 mg QD

Losartan:

50 mg QD

Metformin:

850 mg QD

Neutrophil NETosis and DNA extrusion graphic Flare Medication

Colchicine:

0.6 mg

Prednisone:

40 mg

Actor portrayal, not actual patient.

QD, every day.

KRYSTEXXA is not indicated for the treatment of pain.

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

Meet David

A patient with uncontrolled gout you may see in your practice.

Occupation:

College professor

Patient history icon

Patient History

  • 57-year-old with CKD stage 3b due to type 2 diabetes; diagnosed with gout 8 years ago
  • Third flare this year was resolved 2 weeks ago after missing 2 days of work: currently not complaining of pain
  • Has had a small tophus on his left hand for the past 2 years; often wears gloves to cover it up

Actor portrayal, not actual patient.

Physical and lab evaluation icon Current Treatments

Febuxostat:

80 mg/day

Sitagliptin:

25 mg/day

Losartan:

100 mg/day

Treatment history icon Laboratory Workup

sUA level:

7.5 mg/dL

G6PD:

normal

Albuminuria:

300 mg/g

eGFR:

41 mL/min/1.73 m2

A1C:

7.3%

BP:

124/79 mm Hg

Neutrophil NETosis and DNA extrusion graphic Rescue Meds

Colchicine:

0.6 mg

Prednisone:

40 mg

Actor portrayal, not actual patient.

eGFR, estimated glomerular filtration rate.

Actor portrayal of gout and CKD Stage 4 patient, Lisa

Meet Lisa

A patient with uncontrolled gout you may see in your practice.

Occupation:

Office manager

Patient history icon

Patient History

  • 58-year-old with CKD stage 4 due to ADPKD; diagnosed with gout 7 years ago
  • Has had three flares this year; often complains of pain and swollen and tender joints in hands and feet
  • Has had small tophus on her left foot for the past year and a half, which makes it difficult to walk and wear shoes

Actor portrayal, not actual patient.

ADPKD, autosomal dominant polycystic kidney disease.

Physical and lab evaluation icon Current Treatments

Allopurinol:

200 mg/day

Losartan:

50 mg/day

Treatment history icon Laboratory Workup

sUA level:

7.4 mg/dL

G6PD:

normal

uACR:

80 mg/g

eGFR:

29 mL/min/1.73 m2

BP:

128/78 mm Hg

Neutrophil NETosis and DNA extrusion graphic Rescue Meds

Colchicine:

0.3 mg

Prednisone:

40 mg

Actor portrayal, not actual patient.

ADPKD, autosomal dominant polycystic kidney disease.

eGFR, estimated glomerular filtration rate; uACR, urine albumin-creatinine ratio.

Actor portrayal of gout and kidney transplant patient, Harold

Meet Harold

A patient with uncontrolled gout you may see in your practice.

Occupation:

Journalist

Patient history icon

Patient History

  • 64-year-old with type 2 diabetes, hypertension, and end-stage renal disease
  • Underwent preemptive living-donor kidney transplant several years ago
  • Diagnosed with gout 7 years ago, prior to transplant
  • Has had two flares this year
  • Two or more tophi and complains of pain, swollen ankles, and sore elbows

Actor portrayal, not actual patient.

Physical and lab evaluation icon Current Treatments

Losartan:

50 mg/day

Allopurinol:

300 mg/day

Furosemide:

40 mg/day

Canagliflozin:

100 mg/day

NTreatment history icon Laboratory Workup

uACR:

100 mg/g

G6PD:

normal

sUA level:

7.3 mg/dL

BP:

135/78 mm Hg

eGFR:

57 mL/min/1.73 m2

Neutrophil NETosis and DNA extrusion graphic Rescue Meds

Colchicine:

0.3 mg

Prednisone:

40 mg

Antirejection Meds

Antimetabolite

Calcineurin inhibitor

Low-dose steroid

Actor portrayal, not actual patient.

eGFR, estimated glomerular filtration rate; uACR, urine albumin-creatinine ratio.

CKD, chronic kidney disease.

Support icon

Have a patient who meets these criteria?

Connect with the KRYSTEXXA team to discuss.

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ACR Guidelines

ACR Guidelines strongly recommend pegloticase for your patients with uncontrolled gout.2*

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Antidrug antibodies

How can reducing antidrug antibodies improve patient response?

See the Data

*ACR Guidelines recommend pegloticase in patients who have failed to reach sUA target levels on oral urate-lowering therapies at maximum medically appropriate doses and continue to have frequent gout flares ( >2 flares/year) or nonresolving tophi.1,2

ACR, American College of Rheumatology; sUA, serum uric acid.

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.

  • KRYSTEXXA (pegloticase) [prescribing information] Horizon.
  • FitzGerald JD, et al. Arthritis Care Res (Hoboken). 2020;72(6):744-760.