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Journal Scan
Rheumatology

Methotrexate plus pegloticase shows potential for uncontrolled gout

Posted on September 23, 2020

More patients with uncontrolled gout treated concomitantly with methotrexate and pegloticase maintained therapeutic response at 6 months compared with those receiving pegloticase alone, according to a study published in The Journal of Rheumatology.

In this multicenter, open-label, efficacy and safety study, 14 patients with uncontrolled gout were administered oral methotrexate (15 mg/week) and folic acid (1 mg/day) 4 weeks prior to and throughout treatment with pegloticase. Responders were defined as sUA <6 mg/dL for ≥80% of the time during month 6.

Overall, mean sUA on Day 1 was 9.2 ± 2.5 mg/dL, with 12 patients having visible tophi. At 6 months, 78.6% of patients met responder criteria. Treatment was discontinued in 3 patents after meeting protocol-defined treatment discontinuation rules (pre-infusion sUA values greater than 6 mg/dL at 2 consecutive scheduled visits).

Methotrexate was tolerated and no safety concerns were identified.

The authors note that the therapeutic response at 6 months for patients using pegloticase alone has been reported at 42%.

Further studies are needed to validate these findings.

Reference
Botson JK, Tesser JRP, Bennett R, et al. Pegloticase in combination with methotrexate in patients with uncontrolled gout: A multicenter, open-label study (MIRROR). J Rheumatol. 2020; jrheum.200460; DOI: https://doi.org/10.3899/jrheum.200460.

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