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New Drug May Relieve Severe, Tough-to-Treat Gout
Date:8/16/2011

By Alan Mozes
HealthDay Reporter

TUESDAY, Aug. 16 (HealthDay News) -- For some gout patients afflicted with a particularly severe, crippling form of the disease who find standard treatments either intolerable or ineffective, a recently approved alternative appears to afford relief.

A new injectable treatment called pegloticase (brand name Krystexxa) has no effect on most severe gout patients, but researchers say that for the roughly four in 10 patients who do respond positively, the improvement can be significant.

Use of pegloticase was approved by the U.S. Food and Drug Administration in September 2010.

However, the treatment is expensive and the study found a high rate of side effects, some extremely serious, suggesting that health providers have to weigh the costs and benefits on a case by case basis.

"What we're focusing on here are the approximately 3 percent of gout patients who have the most advanced form of disease," said study senior author Dr. Michael A. Becker, professor emeritus of medicine at the University of Chicago.

"About 80 percent of the time these patients are intolerant of the long-standing medication for gout, allopurinol," Becker explained. "For the other 20 percent, the medication either just doesn't have sufficient efficacy or takes too long to take effect.

"So pegloticase is clearly a niche agent designed specifically for these worst cases," Becker said. "It is an expensive alternative requiring carefully monitored intravenous infusions for a prolonged period of time. And there is a potential for infusion reactions, which can be -- although usually aren't -- severe.

"But the bottom line is that this treatment offers hope for people who have been deemed otherwise not amenable to treatment with conventional agents," he concluded.

Becker and his colleagues published their findings in the Aug. 17 issue of the Journal of the American Medical Association'/>"/>

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