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

grams of pegloticase bi-weekly; a second to receive the drug once a month; and the third placed on injectable saline (a placebo).

The result: all patients receiving pegloticase experienced a rapid drop in their uric acid levels to ranges considered normal. However, in some cases the uric acid decline was temporary, the investigators found.

The study indicated that the new treatment will not help all of the estimated 120,000 to 180,000 Americans with this most severe type of gout. In fact, the medication appeared to elicit an all-or-nothing response, greatly helping some patients while having almost no effect on others.

Ultimately, the research team found that 42 percent of the bi-weekly pegloticase patients maintained normal uric acid levels for a minimum of 80 percent of the half-year study period. The same was true among 35 percent of the monthly pegloticase patients. Those given saline solutions saw no improvement at all.

Overall, the quality of life went up among both sets of pegloticase patients, as did mobility and function; there was also a reduction in pain. What's more, many of the lumps typically associated with long-term gout (called "tophi") resolved in roughly 40 percent and 20 percent of the bi-weekly and monthly pegloticase patients, respectively.

However, the authors said 90 percent of pegloticase patients experienced at least one side effect, most commonly a brief flare-up of gout. Such flare-up side effects are also a common feature among allopurinol patients in the immediate period following treatment launch.

More seriously, about one-quarter of the bi-weekly pegloticase patients and 42 percent who had monthly injections experienced infusion-related immune responses at the drug injection site. In 5 percent to 8 percent of patients, the reaction was serious, and five patients experienced anaphylaxis.

Dr. Tuhina Neogi, an associate professor of medicine at Boston University School of Medicine, said: "The va
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