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November 9, 2011

Pegloticase and Chronic Gout—Reply

Author Affiliations

Author Affiliations: Duke Clinical Research Unit, Duke University Medical Center, Durham, North Carolina (Dr Sundy) (john.sundy@duke.edu); Rheumatology Section, The University of Chicago, Chicago, Illinois (Dr Becker); and Calhoun Cardiology Center, University of Connecticut School of Medicine, Farmington (Dr White).

JAMA. 2011;306(18):1979-1980. doi:10.1001/jama.2011.1617

In Reply: Dr Ea and colleagues acknowledge the demonstrated benefits of pegloticase treatment in refractory chronic gout but express concern about the safety implications of our findings related to both the uricase activity of pegloticase and the immunogenicity of the agent.

A small number of IRs were associated with features of anaphylaxis, but this neither supports nor refutes the need for corticosteroid use with pegloticase. The rationale for including pretreatment with corticosteroids in the prescribing information was derived from the mandate for its use in all patients as prophylaxis against IRs in our clinical trials.