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First Biologic for Gout, Krystexxa, Approved

The FDA has approved biologic drug pegloticase, brand name Krystexxa, to treat severe forms of gout.

By Jennifer Davis

9/17/10 Big news for the estimated 90,000 Americans with gout who don’t find relief from current gout medications. The U.S. Food and Drug Administration, FDA, has approved a new drug called pegloticase, brand name Krystexxa, aimed specifically at helping those patients who don’t get better with conventional treatment.

According to answers sent via e-mail from FDA spokespersons Sarah Okada, MD, Clinical Team Leader, Rheumatology, Division of Pulmonary, Allergy, and Rheumatology Products and Badrul Chowdhury, MD, PhD, Director, Division of Pulmonary, Allergy, and Rheumatology Products, “People with severe chronic gout that has not been adequately controlled on other available therapies now have a therapeutic option that gives them a reasonably good chance of achieving control.”

Gout is a type of arthritis that occurs when uric acid builds up in blood, causing urate crystals to settle in joint, triggering gout attacks of intense pain, inflammation and stiffness. The condition affects more than six million people and more men get the condition then women. Obesity and diabetes are often associated with gout. Genetic factors and diet can also play a role in triggering the condition.

Until now, all gout medications on the market have been pills that are taken orally and prevent gout attacks by lowering uric acid in blood in one of two ways. Most commonly they decrease the production of uric acid by preventing purines, a type of protein produced naturally by the body and found in a variety of foods (such as beer and certain meats and beans), from turning into uric acid so it can’t crystallize in the joints. Other gout drugs increase the excretion of uric acid through urine.

“Patients with insufficient control, or who were not able to tolerate these medications, did not have many options, other than treatment of acute attacks of gout,” according to the e-mail from FDA spokespersons. “Krystexxa provides for the option of a different mechanism of action for patients with chronic gout who have not been adequately controlled with these other therapies, and may be uniquely helpful for treating patients with inadequately controlled severe disease that includes build up of lumps of uric acid crystals.”

Krystexxa also lowers uric acid, but in a different way. The medication is the first biologic developed for gout and requires an intravenous infusion, IV, every two weeks. This is because it involves an enzyme that wouldn’t be absorbed in pill form.

Krystexxa is an enzyme that acts directly on uric acid, turning it into a different molecule, allantoin, that can be readily excreted in the urine,” according to the e-mail from FDA spokespersons.

Stage III clinical trials conducted by scientists at Duke University showed the drug successfully treated gout in about 40 percent of more than 200 study participants.

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Robert Sanchez
15 Mar 2012, 19:58
Im from california and have had gout since i was twelve years old and get it in every joint in my body,iv tried allopurinol and uloric and both work okay but my body has gotten tolerent to it,so i went to see a doctor and stanford hospital and he said the cost of the infusion 50,000 a year to use it,but that it only works short term as your body will become tolerent to it
hopeful sister
12 Jul 2011, 17:37
My brother suffers terribly from gout. When treated w/ allopurinol he had a "reaction," later dx'd as Stephen Johnson's syndrome. All of his skin fell off, his eyes are permanently damaged and he could have died. I pray Krystexxa is the answer to our prayers and he can finally get some relief from his gout pain.
Jerz
17 Feb 2011, 23:56
This drug is for patients that don't respond to conventional therapy! So to the person who said try Uloric! You don't get it! Gout is painful! And this drug will help them! So y don't u try Uloric!
Try Uloric
07 Jan 2011, 23:01
This medication is a last ditch option - requires I.V. infusion every two weeks. If your family members are suffering with chronic gout tell them to go to their doc and get a prescription for Uloric. This med is highly effective, safe and is a pill taken once a day. Much better option than being stuck every two weeks.
tanti
14 Dec 2010, 00:51
email me if anybody know where i can get this drug n the price? My beloved father suffer from this gout a lot , tq.
Gouty
08 Dec 2010, 11:35
When will this drug be available in the philippines
B. GHOSH
29 Oct 2010, 03:56
I am from India and I am sufferung from Gout . When will be the drug Krystexxa
available in India also ?

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