Uricase and other novel agents for the management of patients with treatment-failure gout.
Successful management of chronic gout depends on reducing body pools of urate. The benchmark of success is to maintain serum urate levels at less than 6 mg/dL using therapies such as probenecid or allopurinol. In a subset of patients with gout, these medications fail to achieve this benchmark, resulting in ongoing signs and symptoms characteristic of treatment-failure gout. Potential therapies now in clinical development show promise for treating this refractory patient population. In this article, we review the clinical characteristics associated with treatment-failure gout and discuss recent data from clinical trials of febuxostat and uricase.
Sundy
John S
JS
Duke University Medical Center, Durham, NC 27710, USA. john.sundy@duke.edu
Hershfield
Michael S
MS
D000493:Allopurinol / Q000627:therapeutic use; D000069465:Febuxostat; D006073:Gout / Q000188:drug therapy* / Q000503:physiopathology; D006074:Gout Suppressants / Q000627:therapeutic use*; D006801:Humans; D016032:Randomized Controlled Trials as Topic; D011994:Recombinant Proteins / Q000627:therapeutic use; D013844:Thiazoles / Q000627:therapeutic use*; D017211:Treatment Failure; D014503:Urate Oxidase / Q000627:therapeutic use*; D014527:Uric Acid / Q000097:blood
D006074:Gout Suppressants; D011994:Recombinant Proteins; D013844:Thiazoles; D000069465:Febuxostat; D014527:Uric Acid; D000493:Allopurinol; D014503:Urate Oxidase