Pegloticase plus methotrexate provides greater improvement in gout outcomes, study finds
Combining methotrexate (MTX) with pegloticase treatment improves clinical outcomes and quality of life for patients with uncontrolled gout, according to a study.
The study included 152 patients with uncontrolled gout, characterized by elevated serum urate levels, failed or intolerant urate-lowering therapy, and chronic symptoms such as frequent flares or tophi. Key outcomes assessed included the Physician Global Assessment of Gout (PhGA), tender/swollen joint counts (TJC/SJC), and the gout chronic response rate (GCR50/GCR70).
Patients on pegloticase with MTX had better outcomes than those on pegloticase with placebo. At week 52, patients in the MTX group had significantly more improvement in clinical measures, with higher percentages meeting the GCR50 (58.0% vs 38.5%) and GCR70 (52.0% vs 30.8%) criteria. Both groups showed similar improvements in PhGA and joint counts, but the MTX group had a higher sustained SU-lowering rate (60.0% vs 30.8%).
The researchers concluded that pegloticase improves clinical outcomes and quality of life in patients with uncontrolled gout, but those receiving methotrexate co-therapy may experience greater benefits.
Reference
Botson J, Obermeyer K, LaMoreaux B, et al. Quality of life and clinical gout assessments during pegloticase with and without methotrexate co-therapy: MIRROR randomized controlled trial exploratory findings. Rheumatol Adv Pract. 2024;8(4):rkae145. doi: 10.1093/rap/rkae145. PMID: 39678124; PMCID: PMC11646119.
