Summary of precautions you must know when using Pegloticase

During the treatment with Pegloticase (Pegloticase), you need to pay attention to certain safety matters to ensure the efficacy and patient safety.

1.High risk of allergic reactions:Pegloticase can induce severe infusion-related reactions and even anaphylactic shock. Clinical trial data show that approximately 25% of patients experience infusion reactions, including urticaria, chest tightness, dyspnea, hypotension, etc. To reduce risk, pretreatment with antihistamines and corticosteroids is necessary before each infusion.

2.G6PDDisabled in patients with deficiency: This drug can induce methemoglobinemia or hemolytic reaction, so patients should be screened for glucose-6-phosphate dehydrogenase (G6PD) deficiency before use. This product should be disabled in patients diagnosed with deficiency.

3.Uric acid monitoring is critical: serum uric acid levels should be measured before each infusion during treatment. If two consecutive measured values u200bu200bare found to be higher than 6 mg/dL, it means that the patient may have produced antibodies, which will affect the metabolism of Pegloticase and increase the risk of serious reactions. At this time, the drug should be stopped immediately.

4.Discontinue other urate-lowering drugs: drugs such as allopurinol or febuxostat may mask signs of Pegloticase failure. Therefore, other urate-lowering treatments should be discontinued before using Pegloticase to avoid interfering with efficacy evaluation.

5.Infusion environment and observation requirements: It is recommended that infusion be carried out in a medical institution with emergency rescue facilities, and the patient's vital signs should be monitored for at least 1 hours after each dose, so as to identify adverse reactions early.

6.Gout attacks may increase: The rapid drop in blood uric acid in the early stage of treatment may induce acute gout attacks. Therefore, it is recommended to give anti-inflammatory drugs (such as colchicine or non-steroidal anti-inflammatory drugs) prophylactically before starting treatment and in the early stages of treatment.

Reference materials:https://en.wikipedia.org/wiki/Pegloticase