Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 209.6 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Deprecated: Implicit conversion from float 243.2 to int loses precision in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 534
Warning: imagejpeg(C:\Inetpub\vhosts\kidney.de\httpdocs\phplern\24588936
.jpg): Failed to open stream: No such file or directory in C:\Inetpub\vhosts\kidney.de\httpdocs\pget.php on line 117 Arthritis+Res+Ther
2014 ; 16
(2
): R60
Nephropedia Template TP
gab.com Text
Twit Text FOAVip
Twit Text #
English Wikipedia
Pegloticase immunogenicity: the relationship between efficacy and antibody
development in patients treated for refractory chronic gout
#MMPMID24588936
Lipsky PE
; Calabrese LH
; Kavanaugh A
; Sundy JS
; Wright D
; Wolfson M
; Becker MA
Arthritis Res Ther
2014[Mar]; 16
(2
): R60
PMID24588936
show ga
INTRODUCTION: The efficacy of pegloticase, a polyethylene glycol (PEG)-conjugated
mammalian recombinant uricase, approved for chronic refractory gout, can be
limited by the development of antibodies (Ab). Analyses from 2 replicate,
6-month, randomized controlled trials were performed to characterize Ab responses
to pegloticase. METHODS: Anti-pegloticase, anti-PEG, and anti-uricase Ab were
determined by validated enzyme-linked immunosorbent assays. Ab titers were
analyzed for possible relationships with serum pegloticase concentrations, serum
uric acid (sUA) lowering, and risk of infusion reactions (IRs). RESULTS:
Sixty-nine (41%) of 169 patients receiving pegloticase developed high titer
anti-pegloticase Ab (> 1:2430) and 40% (67/169) developed anti-PEG Ab; 1 patient
receiving placebo developed high titer anti-pegloticase Ab. Only 14% (24/169) of
patients developed anti-uricase Ab, usually at low titer. In responders, patients
showing sustained UA lowering, mean anti-pegloticase titers at week 25 (1:837 ±
1687 with biweekly and 1:2025 ± 4506 with monthly dosing) were markedly lower
than in nonresponders (1:34,528 ± 42,228 and 1:89,658 ± 297,797, respectively).
Nonresponder status was associated with reduced serum pegloticase concentrations.
Baseline anti-pegloticase Ab, evident in 15% (31/212) of patients, did not
predict subsequent loss of urate-lowering response. Loss of sUA response preceded
IRs in 44 of 56 (79%) pegloticase-treated patients. CONCLUSIONS: Loss of
responsiveness to pegloticase is associated with the development of high titer
anti-pegloticase Ab that increase clearance of pegloticase and are associated
with a loss of the sUA lowering effect and increased IR risk. Pre-infusion sUA
can be used as a surrogate for the presence of deleterious anti-pegloticase Ab.
TRIAL REGISTRATION: NCT00325195. Registered 10 May 2006, NCT01356498. Registered
27 October 2008.