Kidney Week

Abstract: FR-PO216

Stage of CKD Does Not Affect the Velocity of Tophus Reduction in Patients with Chronic Refractory Gout Treated with Pegloticase

Session Information

• CKD: Clinical, Outcomes, Trials - II
  October 26, 2018 | Location: Exhibit Hall, San Diego Convention Center
  Abstract Time: 10:00 AM - 12:00 PM

Category: CKD (Non-Dialysis)

• 1902 CKD (Non-Dialysis): Clinical, Outcomes, and Trials

Authors

• Mandell, Brian F., Cleveland Clinic, Cleveland, Ohio, United States

Brian F. Mandell,

• Pillinger, Michael, NYU School of Medicine, New York, New York, United States

Michael Pillinger,

• Edwards, N. Lawrence, University of Florida College of Medicine, Gainesville, Florida, United States

N. Lawrence Edwards,

• Johnson, Richard J., University of Colorado Denver , Aurora, Colorado, United States

Richard J. Johnson,

• Yeo, Anthony, Horizon Pharma, Lake Forest, Illinois, United States

Anthony Yeo,

• Lipsky, Peter E., AMPEL BioSolutions, Charlottesville, Virginia, United States

Peter E. Lipsky,

Background

Impaired renal function is a recognized comorbidity of gout and gouty tophi may be more frequent in those with renal dysfunction. It is not known however, whether the velocity of resolution of tophi in response to urate lowering therapy is affected by renal insufficiency.

Methods

This analysis used results from two 6-month randomized controlled trials of pegloticase in patients with chronic refractory gout to address this issue. The velocity of tophus resolution was determined in 18 patients with chronic gout refractory to oral urate lowering therapy who responded to pegloticase administered at a dose of 8 mg every 2 weeks (q2w) with sustained serum urate reductions (<6 mg/dL) over 6 months. eGFR was determined at baseline and after 3 and 6 months of treatment. Tophi were photographed at baseline, 3, 4.5, and 6 months and measured using Computer-Assisted Photographic Evaluation technology. At baseline, the mean area of photographed tophi was 585.8 mm².

Results

Complete resolution of all tophi photographed was achieved by 34.8% of the patients. Using linear regression analysis, the velocity of tophus resolution for all the patients was calculated to be 60.1 mm² per month. There was no significant relationship between baseline eGFR and velocity of tophus resolution (p=0.5). In addition, there were no significant differences in the velocity of tophus resolution for patients with Stage 1 chronic kidney disease (CKD) vs Stage 2 CKD (P=0.7), Stage 3 CKD (P=0.9), or Stage 4 CKD (P=0.7).

Conclusion

The results from this analysis thus indicate that renal impairment does not compromise the ability of pegloticase to resolve tophi rapidly in patients who respond with sustained reductions in serum urate.

Funding

• Commercial Support – Horizon Pharma