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Evaluate Your Gout Patients Using1
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:

  • ANDREW
  • BET

Meet Andrew, a patient you may see in your practice

Patient name/age:

Andrew, 56

Occupation:

Real estate agent

Actor portrayal, not actual patient.
Patient history icon

Patient History

  • Diagnosed with gout 8 years ago
  • Flares: 4 in the last year
    • 2 resulted in urgent care visits
    • 2 mitigated with flare prophylaxis
  • Pain: complaining of pain in his hands and feet
  • Tophi: pea-sized tophus on his right hand for the past 2 years; golf ball–sized tophus on left ankle; both nonresolving
  • Comorbidities: hypertension

sUA, serum uric acid.
KRYSTEXXA is not indicated for the treatment of pain.

Laboratory Workup

sUA:

8.4 mg/dL

BMI:

31

G6PD:

normal

BP:

128/80

Renal function:

normal

Treatment history icon Current Treatment

Allopurinol:

600 mg QD (for the past year)

Losartan:

50 mg QD

Flare Medication

Colchicine:

0.6 mg QD for prophylaxis

Prednisone:

40 mg

Patient Background
  • When Andrew greets clients, he extends his left hand to shake so they avoid seeing the tophus
  • Increased discomfort and pain due to flares have caused Andrew to remain home more often, sometimes leading to a loss of potential real estate clients. The resulting financial burden is causing him stress and anxiety

sUA, serum uric acid.
KRYSTEXXA is not indicated for the treatment of pain.

Learn about Bet, a real patient on KRYSTEXXA

Before KRYSTEXXA with methotrexate

Bet story Icon

REAL PATIENT

Patient name/age:

Bet, 43

Occupation:

Stay-at-home parent

Patient history icon

Patient History

  • A father and husband who loves spending time with his children
  • Has had gout for over 20 years
  • Stopped working construction due to pain and limited mobility
  • No known comorbidities

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

Physical and lab evaluation icon Physical & Lab Evaluation

sUA:

>6 mg/dL

BMI:

38.5

Tophi:

Visible tophi

Swollen, tender joints:

Chronic pain in multiple joints

Flares:

>2/year

Treatment history icon Treatment History

Allopurinol:

7 years with increasing doses

Febuxostat:

1 year

Colchicine:

7 years while flaring

The ACR Guidelines STRONGLY RECOMMEND pegloticase for patients like Bet1

KRYSTEXXA can be co-administered with methotrexate2

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

After KRYSTEXXA with methotrexate

bet story Icon

REAL PATIENT

Patient name/age:

Bet, 43

Occupation:

Stay-at-home parent

“I wish I had started KRYSTEXXA (with methotrexate) sooner. Now, I go out and do things and not just want to stay at home. I’m definitely in a better place now.”

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.

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

Neutrophil NETosis and DNA extrusion graphic Physical & Lab Evaluation

sUA:

<1 mg/dL

Tophi:

Reduced

Functional status:

Can walk and perform daily activities

Swollen/tender joints:

Chronic pain in multiple joints

BMI:

41.1

Neutrophil NETosis and DNA extrusion graphic Treatment History

Colchicine:

0.6 mg as needed

KRYSTEXXA:

8 mg every two weeks

Methotrexate:

15 mg orally per week

The ACR Guidelines STRONGLY RECOMMEND pegloticase for patients like Bet1

KRYSTEXXA can be co-administered with methotrexate2

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

Have a patient who might
be ready for KRYSTEXXA?

Connect with the KRYSTEXXA team to discuss the ACR Guidelines and treatment criteria.

Request Support

Antidrug antibodies

How can reducing antidrug antibodies improve patient response?

See the Data

ACR, American College of Rheumatology.

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.

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