Cailin Conner

DocwireNews

Kidney transplant recipients are known to have a higher prevalence and severity of gout compared with the general population. To address the challenges faced by these patients, a recent phase 4 clinical trial has evaluated the safety and efficacy of pegloticase, a pegylated recombinant uricase, in treating uncontrolled gout among kidney transplant recipients.Per the authors of this study, published in Clinical Transplantation, &ldquo;The aim of this phase 4, multisite, open-label trial (PROTECT NCT04087720) was to examine the safety and efficacy of pegloticase in kidney transplant participants on immunosuppression with chronic gout refractory to conventional urate lowering therapy.&rdquo;The trial included 20 participants who had received a kidney transplant at least 1 year prior to enrollment. The study enrolled individuals who had uncontrolled gout, characterized by a serum uric acid (sUA) level of &ge;7 mg/dL, intolerance or inefficacy to urate lowering therapy, and at least 1 of the following criteria: presence of tophi, chronic gouty arthritis, or a history of 2 or more gout flares within the past year. All participants had a functioning kidney transplant, with an estimated glomerular filtration rate of &ge;15 mL/min/1.73 m&sup2; and were on stable immunosuppression therapy.The primary endpoint of the study was the response of sUA levels during the sixth month, with the goal of achieving sUA levels consistently below 6 mg/dL for at least 80% of the time. Mean participant age was 53.9&plusmn;10.9 years, and the average time since kidney transplantation was 14.7&plusmn;6.9 years. The participants had an average sUA level of 9.4&plusmn;1.5 mg/dL and a gout duration of 8.4&plusmn;11.6 years. All participants were receiving at least 2 stable doses of immunosuppression agents.The administration of pegloticase (8 mg intravenous every 2 weeks) to kidney transplant recipients with uncontrolled gout demonstrated an impressive response rate of 89% (16 out of 18 responders). Two participants discontinued treatment solely due to concerns related to COVID-19 prior to completing 6 months of treatment and were not included in the primary analysis. Notably, pegloticase exposures in this trial were higher than those historically observed with pegloticase monotherapy, indicating a potential benefit of this treatment approach. Moreover, the study reported no incidents of anaphylaxis or infusion reactions during the course of treatment.The trial had several limitations. According to the authors of the study, &ldquo;Limitations for this study include its open-label design, lack of a control group, small participant enrollment, and the broad diversity of immunosuppression regimens used among participants.&rdquo;Considering the elevated prevalence of gout among kidney transplant recipients and the limitations associated with oral urate lowering medications, these results suggest that pegloticase may offer a promising therapeutic option for managing uncontrolled gout in this specific population. Further studies are warranted to confirm these findings and assess the long-term efficacy and safety of pegloticase in kidney transplant recipients with gout.Source: <a href="https://onlinelibrary.wiley.com/doi/full/10.1111/ctr.14993" target="_blank" rel="noopener">Clinical Transplantation</a>

Sara Nunnery, MD, MSCI

Reclassifying HER2: What Oncologists Need to Know About HER2-Low and -Ultralow Breast Cancer

HER2 Breast Cancer

Jeffrey Perl, MD

Joel M. Topf, MD, FACP

Thoughts From the 2025 Lazarus Award Winner

NKF Spring Clinical Meetings 2025

Brandon Twyford

DESTINY-Breast09 Demonstrates First-Line Superiority of Enhertu Plus Pertuzumab in HER2-Positive Metastatic Breast Cancer

Latest News

Pegloticase Shows Promise in Treating Uncontrolled Gout Among Kidney Transplant Recipients

Gout

A phase 4 trial investigating the use of pegloticase in kidney transplant recipients with uncontrolled gout demonstrated a high response rate of 89%.

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

Hyperkalemia

IgAN

Kidney Transplantation

Metabolic Acidosis

Nephrology Times

HR Breast Cancer

Triple-Negative 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