Evidence map›Paper›PMID 38609967›Full record

ArticleArthritis research & therapy2024

Urate-lowering therapy, serum urate, inflammatory biomarkers, and renal function in patients with gout following pegloticase discontinuation.

Emily E Holladay, Amy S Mudano, Fenglong Xie, Jingyi Zhang, Ted R Mikuls, Brian LaMoreaux, Lissa Padnick-Silver, Jeffrey R Curtis

Abstract read
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Article in Arthritis research & therapy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

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3citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

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3 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

8 authors.

Emily E HolladayUniversity of Alabama at Birmingham, 1825 University Blvd, Birmingham, AL, 35233, USA.
Amy S MudanoFoundation for Advancing Science, Technology, Education, and Research, Birmingham, AL, USA.
Fenglong XieUniversity of Alabama at Birmingham, 1825 University Blvd, Birmingham, AL, 35233, USA.
Jingyi ZhangUniversity of Alabama at Birmingham, 1825 University Blvd, Birmingham, AL, 35233, USA.
Ted R MikulsUniversity of Nebraska Medical Center and the VA Nebraska-Western Iowa Health Care System, Omaha, NE, USA.
Brian LaMoreauxHorizon Therapeutics Plc (Now Amgen Inc.), Deerfield, IL, USA.
Lissa Padnick-SilverHorizon Therapeutics Plc (Now Amgen Inc.), Deerfield, IL, USA.
Jeffrey R CurtisUniversity of Alabama at Birmingham, 1825 University Blvd, Birmingham, AL, 35233, USA. jrcurtis@uabmc.edu.ORCID 0000-0002-8907-8976

Funding

Methods and Health Informatics CoreP30AR072583 · NIAMS · UNIVERSITY OF ALABAMA AT BIRMINGHAM · PI JEFFREY R. CURTIS · 2020 to 2026
$5.7M
NIAMS NIH HHS P30 AR072583NIAMS NIH HHS P30AR072583
6 · The paper itself

Abstract

background/purposeLittle is known about long-term clinical outcomes or urate-lowering (ULT) therapy use following pegloticase discontinuation. We examined ULT use, serum urate (SU), inflammatory biomarkers, and renal function following pegloticase discontinuation.

methodsWe conducted a retrospective analysis of gout patients who discontinued pegloticase using the Rheumatology Informatics System for Effectiveness (RISE) registry from 1/2016 to 6/2022. We defined discontinuation as a gap ≥ 12 weeks after last infusion. We examined outcomes beginning two weeks after last dose and identified ULT therapy following pegloticase discontinuation. We evaluated changes in lab values (SU, eGFR, CRP and ESR), comparing on- treatment (≤ 15 days of the second pegloticase dose) to post-treatment.

resultsOf the 375 gout patients discontinuing pegloticase, median (IQR) laboratory changes following discontinuation were: SU: +2.4 mg/dL (0.0,6.3); eGFR: -1.9 mL/min (- 8.7,3.7); CRP: -0.8 mg/L (-12.8,0.0); and ESR: -4.0 mm/hr (-13.0,0.0). Therapy post-discontinuation included oral ULTs (86.0%), restarting pegloticase (4.5%), and no documentation of ULT (9.5%), excluding patients with multiple same-day prescriptions (n = 17). Oral ULTs following pegloticase were: 62.7% allopurinol, 34.1% febuxostat. The median (IQR) time to starting/restarting ULT was 92.0 days (55.0,173.0). Following ULT prescribing (≥ 30 days), only 51.0% of patients had SU < 6 mg/dL. Patients restarting pegloticase achieved a median SU of 0.9 mg/dL (IQR:0.2,9.7) and 58.3% had an SU < 6 mg/dL.

conclusionPegloticase treats uncontrolled gout in patients with failed response to xanthine oxidase inhibitors, but among patients who discontinue, optimal treatment is unclear. Based on this analysis, only half of those starting another ULT achieved target SU. Close follow-up is needed to optimize outcomes after pegloticase discontinuation.

Indexed as

GoutPolyethylene GlycolsUrate OxidaseUric AcidBiomarkersHumansKidneyRetrospective StudiesBiomarkersPegloticasePolyethylene GlycolsUrate OxidaseUric AcidDiscontinuationGoutPegloticaseRestartTreatment gap

Identifiers

PMID38609967
PMCPMC11010378

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.