A full scan of possible side effects of Pegloticase

Although Pegloticase (Pegloticase) is effective in treating refractory gout, its incidence of adverse reactions is high and requires great attention. Side effects are mainly divided into infusion-related reactions, immune reactions, metabolism-related reactions and other systemic reactions.

1.Infusion-related reactions: The most common adverse reactions are allergic symptoms that occur during or shortly after infusion, including rash, itching, urticaria, flushing, chest tightness, throat tightness, shortness of breath, hypotension, etc. In clinical trials, approximately 25% of patients experienced infusion reactions of varying degrees, some of which were severe and required treatment to be discontinued. Pretreatment before infusion (antihistamine+glucocorticoid) is key to prevention.

2.Severe allergic reactions and immunogenicity: Some patients will produce anti-Pegloticase antibodies, thereby reducing the efficacy of the drug and increasing the incidence of infusion-related reactions. In such patients, the level of uric acid in the body cannot be maintained reduced. It is common for allergic reactions to worsen after infusion, and even cause serious complications such as anaphylactic shock, bronchospasm, or angioedema.

3.Gout attacks: In the early stages of treatment, rapid uric acid decline can stimulate the disintegration of tophi, leading to an increase in the frequency of acute gout attacks. This condition is most common in the first few months and can be controlled clinically by preventive use of colchicine or NSAIDs.

4.Hematology and metabolic abnormalities: Some patients may develop anemia and methemoglobinemia (especially those with G6PD deficiency), which are related to Pegloticase metabolic mechanism and oxidative stress. G6PD screening should be performed before use to prevent severe hemolytic reactions.

5.Other reactions: including nausea, constipation, fatigue, back pain, fever, injection site reactions, etc., are usually mild to moderate and can be relieved in the short term.

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