Krystexxa® (pegloticase – Horizon Therapeutics) has received an expanded indication for co-administration with methotrexate to treat chronic gout in adults whose disease is refractory to conventional therapy.

• First FDA approved in 2010, Krystexxa was originally as a single therapy to treat gout. Gout is an inflammatory condition that causes uric acid to crystallize and form deposits in the joints.
• Recommended dosing under the expanded indication is 8mg of Krystexxa given as an intravenous infusion once every two weeks, co-administered with weekly oral methotrexate (15mg once a week week) and folic acid or folinic acid supplementation.
  • Methotrexate and folic acid or folinic acid supplementation should be started at least four weeks prior to initiating Krystexxa.
  • Krystexxa can be used alone in patients for whom methotrexate is contraindicated or not clinically appropriate.