Tophus resolution with pegloticase: a prospective dual-energy CT study

Araujo EG, Bayat S, Petsch C, Englbrecht M, Faustini F, Kleyer A, Hueber A, Lell M, Dalbeth N, Manger B, Schett G, Rech J, Cavallaro AJ (2015)

Publication Type: Journal article

Publication year: 2015

Journal

RMD Open BMJ Publishing Group

Book Volume: 1

Pages Range: e000075

Journal Issue: 1

DOI: 10.1136/rmdopen-2015-000075

Abstract

To investigate the effect of intensive lowering of serum uric acid (SUA) levels by pegloticase on the resolution of tophi in patients with refractory gout.Descriptive study in patients with refractory gout receiving pegloticase treatment. SUA levels were measured before and after each infusion. Dual-energy CT (DECT) scans were taken from all patients before the first infusion and after the last infusion. Computerised tophus volumes were calculated for the baseline and follow-up assessments and compared with each other.10 patients with refractory gout and baseline mean SUA level of 8.1 mg/dL were enrolled. Patients were treated for a mean of 13.3 weeks. Pegloticase effectively reduced tophi in all patients showing a decrease in volume by 71.4%. Responders, showing reduction of SUA level below 6 mg/dL during at least 80% of the treatment time, were virtually cleared from tophi (-94.8%). Dependent on their anatomical localisation, resolution of tophi showed different dynamics, with articular tophi showing fast, and tendon tophi slow, resolution.Tophi are highly sensitive to pegloticase treatment, particularly when located at articular sites. Debulking of disease and a tophus-free state can be reached within a few months of pegloticase treatment. DECT allows for comprehensively assessing tophus burden and monitoring treatment responses.

Authors with CRIS profile

Christina Petsch Lehrstuhl für Innere Medizin III Matthias Englbrecht Lehrstuhl für Innere Medizin III Arnd Kleyer Department of Medicine 3 – Rheumatology and Immunology Axel Hueber Department of Medicine 3 – Rheumatology and Immunology Michael Lell Medizinische Fakultät Bernhard Manger Professur für Rheumatologie und Klinische Immunologie Georg Schett Lehrstuhl für Innere Medizin III Alexander Josef Cavallaro Institute of Radiology

Involved external institutions

University of Auckland NZ New Zealand (NZ)

How to cite

APA:

Araujo, E.G., Bayat, S., Petsch, C., Englbrecht, M., Faustini, F., Kleyer, A.,... Cavallaro, A.J. (2015). Tophus resolution with pegloticase: a prospective dual-energy CT study. RMD Open, 1(1), e000075. https://doi.org/10.1136/rmdopen-2015-000075

MLA:

Araujo, Elizabeth G., et al. "Tophus resolution with pegloticase: a prospective dual-energy CT study." RMD Open 1.1 (2015): e000075.

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