1 What is Krystexxa?

Brand: Krystexxa

Generic: Pegloticase

Krystexxa is used to treat severe chronic or longstanding gout. Pegloticase is a urate-oxidase enzyme medication.

Gout or gouty is a type of arthritis caused by excessively high uric acid levels. At elevated concentrations, uric acid forms crystals that look like needles that cause irritation to the joints (especially the joint of the big toe), the formation of tophi (skin growths filled with uric acid) and formation of kidney stones.

Pegloticase works by converting uric acid into allantoin, preventing it from turning into crystals and allowing easier elimination through the urine. Doctors prescribe Pegloticase to treat adult cases of chronic gout that resisted conventional treatments. Pegloticase works in the body for as long as 12 days.

Pegloticase requires a prescription. It is available as a sterile fluid for infusion into the veins. Only use Pegloticase according to doctor’s instructions.

Pegloticase may cause severe allergic or hypersensitivity reactions. In some cases, Pegloticase may cause an allergic reaction at the first infusion or several hours or days later (delayed reaction). The patient must be closely monitored by a health professional during the administration of Pegloticase.

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2 What to know before using

Before using Krystexxa, you must know all about the risks and complications associated with it.

If you experienced allergies to Pegloticase before, tell it to the doctor right away. You cannot use Pegloticase if you are allergic to it.

Pegloticase may cause severe allergic reaction anytime, even if you are already receiving it for a long time. Call your health providers right away if you experience any untoward symptoms while receiving Pegloticase.

Pegloticase should not be used by patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency.

Before receiving Pegloticase, make sure to mention all of your health conditions.

Tell the doctor if you have the following health issues:

Pegloticase is approved for treatment of adult cases of gout only. It cannot be used on children and patients below 21 years of age.

Tell the doctor all the medicines you take before receiving Pegloticase. This will help reduce the incidence of drug interactions, which can cause adverse effects.

Tell the doctor if you use the following medications:

  • Allopurinol
  • Certolizumab
  • Febuxostat
  • Pegademase Bovine
  • Pegaptanib
  • Pegaspargase
  • Pegfilgrastim
  • Peginterferon Alfa-2a
  • Peginterferon Alfa-2b
  • Pegvisomant
  • Probenecid

3 Proper usage

To use Krystexxa properly, you must follow all instructions given by your doctor.

Pegloticase is administered by infusing into the veins (intravenous route). It is given every two weeks, and you can only have it in the hospital or doctor’s clinic. Usually, doctors do not allow patients to receive Pegloticase at home due to the need for close monitoring.

The doctor may also order additional medicines such as antihistamines and corticosteroids to reduce the risk of adverse effects of Pegloticase. Note that using Pegloticase for the first few times may cause increased gout flareups. To control gout flareups, the doctor may also order non-steroidal anti-inflammatory drugs (such as Naproxe) and Colchicine a week before administration of Pegloticase.

Only health professionals can give Pegloticase. The medicine is given by injecting into the vein using an infusion pump designed to administer Pegloticase gradually. Pegloticase must be given very slowly, and infusion usually takes at least two hours.

During infusion of Pegloticase, you will be closely monitored by health professionals for allergic reactions or side effects.

You will receive Pegloticase once every two weeks, and it is very important not to miss appointments for infusion of the medication. Because it is given by health professionals, you are unlikely to overdose on Pegloticase.

4 Precautions to take

Before using Krystexxa, there are some precautions you must take.

Always report any untoward symptoms when receiving Pegloticase. It is not uncommon for allergic reactions to occur at least two hours after the infusion. In case reactions occur during infusion of Pegloticase, call your health providers so the doctor can slow or delay administration of the drug.

You may experience increased gout flareups while receiving first few infusions of Pegloticase. Usually, this is not a reason to stop using Pegloticase. The doctor usually orders NSAIDs and Colchicine given one week before infusion of Pegloticase to reduce gout flareups and continue to do so for 6 months. Make sure to follow your doctor’s instructions for receiving Pegloticase.

You need to have undergone regular blood tests when receiving Pegloticase so the doctor can know how long to continue treatment.

5 Potential side effects

As with many medications, there are several potential side effects associated with Krystexxa.

Call your doctor if you experience the following while receiving Pegloticase:

  • Severe allergic reaction such as hives, wheezing, difficulty breathing, swelling of the mouth, tongue, throat and lips
  • Infusion reaction symptoms such as itching, nervousness, anxiety, lightheadedness, shortness of breath, chest discomfort, and redness of the skin while or shortly after infusion of Pegloticase
  • Chest pain
  • Flushing

Pegloticase may cause minor side effects such as: