Which medications in the drug class Rheumatologics, Other are used in the treatment of Gout and Pseudogout?

Updated: Jan 26, 2021
  • Author: Bruce M Rothschild, MD; Chief Editor: Herbert S Diamond, MD  more...
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Answer

Rheumatologics, Other

Uricase facilitates conversion of urate to allantoin. Unlike uric acid, allantoin is soluble and easily excreted by the kidneys. Thus, hyperuricemia is reduced, with little risk of acute kidney injury.

Pegloticase (Krystexxa)

Pegloticase is a pegylated uric acid–specific enzyme that is a polyethylene glycol conjugate of recombinant uricase. It achieves its therapeutic effect by catalyzing oxidation of uric acid to allantoin, thereby lowering serum uric acid levels. Pegloticase is indicated for gout in adults refractory to conventional therapy (ie, when serum uric acid levels have not normalized and either signs and symptoms are inadequately controlled with xanthine oxidase inhibitors or uricosurics at maximum appropriate doses or xanthine oxidase inhibitors are contraindicated).

The dosage is 8 mg IV every 2 weeks. Complications include anaphylaxis, infusion reactions, flare of gout attacks in 63-86% of patients and nephrolithiasis in 13-14%, along with arthralgias, nausea, dyspepsia, muscle spasms, pyrexia, back pain, diarrhea, and rash. [142, 143] Glucose-6-phosphate dehydrogenase (G6PD) deficiency is a contraindication. [143]


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