Victoria Socha

DocwireNews

Decline in renal function is associated with hyperuricemia and gout. Independent of chronic kidney disease (CKD) stage, pegloticase has been shown to lower uric acid in patients with CKD and uncontrolled gout. Data from recent trials and case data support use of an immunomodulator with pegloticase to limit formation of antidrug antibody, increase urate-lowering response rate, and decrease the risk of infusion reaction.CKD may limit immunomodulator use. Patients with estimated glomerular filtration rate (eGFR) &lt;40 mL/min/1.73 m2 were excluded from clinical trials of pegloticase plus immunomodulator (methotrexate [MTX]). However, according to Brad A. Marder, MD, and colleagues, gout is common in patients with CKD and use of pegloticase plus immunomodulator has been reported.The researchers performed an analysis of case data to examine changes in eGFR during cotherapy with pegloticase + MTX in patients with and without CKD. Results were reported during a poster session at the American Society of Nephrology Kidney Week 2022 in a poster titled eGFR Changes in Uncontrolled Gout Patients Undergoing Pegloticase Plus Methotrexate Co-TherapyThe retrospective analysis included pooled deidentified case data of pegloticase + MTX cotherapy. Patients were labeled as CKD (defined as baseline eGFR &lt;60 mL/min/1.73 m2) or non-CKD (baseline eGFR &ge;60 mL/min/1.73 m2). Serum uric acid, eGFR, blood cell counts, and liver function tests were monitored. Patient characteristics, treatment parameters, response rate (&ge;12 infusions, preinfusion 12 serum uric acid &lt;6 mg/dL), eGFR, and adverse events were assessed. Response analyses excluded patients with &lt;12 infusions who remained on therapy at time of data collection.The analysis included data on 42 patients with uncontrolled gout. Of those, 15 were in the CKD group (13 stage 3 and 2 stage 4) and 27 were categorized as non-CKD. The comorbidity profiles of the two groups were similar; more patients in the CKD group were female (33% vs 7%) and &ge;65 years of age (60% vs 19%).In both groups, MTX was initiated approximately 4 weeks prior to pegloticase; the patients with CKD had a lower dose (15 vs 19 mg/week). The pegloticase response rates were similar in both groups (CKD, 92% vs non-CKD, 86%). In patients without CKD, 44% had an increase in eGFR (mean increase, +4.2 mL/min/1.73 m2). In patients with CKD, 60% had an increase in eGFR (mean increase, +11.5 mL/min/1.73 m2).A total of 13 patients in the CKD group had stability/improvement in CKD stage (87%, both stage 4 improved to stage 3a and two stage 3a improved to stage 3b). There were no new safety signals identified. Seven patients in the CKD group (47%) and 13 in the non-CKD group (48%) had one or more adverse events (most commonly gout flare, 47 % and 41%, respectively). Pancytopenia (n=1) and mild immune response (n=1) were reported in the non-CKD group.&ldquo;These limited data show similar pegloticase + MTX urate-lowering efficacy in CKD and non-CKD patients. Most CKD patients had renal stability/improvement during therapy, but further study is needed,&rdquo; the researchers said.Source: Marder BA, Albert JA, Broadwell A, Padnick-Silver L, LaMoreaux B. eGFR changes in uncontrolled gout patients undergoing pegloticase plus methotrexate co-therapy. SA-PO897. Abstract of a poster presented at the American Society of Nephrology Kidney Week 2022; November 5, 2022; Orlando, Florida. Funding for this study was provided by Horizon Therapeutics.

Jayme Locke, MD, MPH

Joel M. Topf, MD, FACP

The Promise of Xenotransplantation

NKF Spring Clinical Meetings 2025

Leah Lawrence

Real-World Data Backs Invasive DFS as Surrogate Endpoint for OS in EBC

HR Breast Cancer

Sacituzimab Govitecan Showed Modest Activity for CNS Metastases

Triple-Negative Breast Cancer

Latest News

Changes in eGFR in Patients Treated for Gout With Pegloticase + Methotrexate

ASN Kidney Week 2022

Decline in renal function is associated with hyperuricemia and gout. Independent of chronic kidney disease (CKD) stage, pegloticase has been shown to lower uric acid in ...

About Us

Editorial Policy

Advertising

Contact Us

eNewsletters

Contribute

Career Center

MashupMD

Blood Cancers Today

Cancer Nursing Today

GU Oncology Now

Urban Health Today

Bile Duct Cancer

Colorectal Cancer

Gastroesophageal Cancer

Gastric Cancer

GEP-NETs

GIST

Liver Cancer

Pancreatic Cancer

GI Oncology Now

Anemia

Deep Vein Thrombosis

Essential Thrombocythemia

Hemophilia

Immune Thrombocytopenic Purpura

Myelodysplastic Syndromes

Myelofibrosis

Myeloproliferative Neoplasms

Polycythemia Vera

Pulmonary Embolism

Sickle Cell Disease

Thrombocytopenia

Thrombophilia

Thrombosis

Thrombotic Thrombocytopenic Purpura

Venous Thromboembolism

von Willebrand Disease

Heme Today

Acute Kidney Injury

ADPKD

Anemia and Kidney Disease

Chronic Kidney Disease

COVID-19 and Kidney Disease

Diabetes and Hypertension

End-Stage Renal Disease

Gout

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HER2 Breast Cancer

Genetics & Breast Cancer

Breast Cancers Today

Atherosclerotic Disease

Atrial Fibrillation

Heart Failure

Hypertension

Interventional Cardiology

Lipid Management

Practice Tips With Dr. Lichaa

Preventive Cardiology

Stroke

Cardiology

Breast Cancer

Gynecologic Cancer

Head and Neck Cancer

Skin Cancer

Oncology

Sleep

Urology

Diabetes

Ophthalmology

— Demodex Blepharitis

Neurology

Rheumatology

Gastroenterology

Pulmonology

Infectious Diseases

— HIV

Health and Wellness

Lupus

Future of Medicine

Orthopedics

Pharmacology

Career News

More

Conferences

CardioNerds

The Sleep Source With Dr. Morse

Rheumatology Rounds With Dr. Maheswaranathan

Partners

Expert Interviews

Subscribe