Monosodium urate crystal depletion and bone erosion remodeling during pegloticase treatment in patients with uncontrolled gout: Exploratory dual-energy computed tomography findings from MIRROR RCT
- Patients who prematurely discontinued pegloticase maintained serum urate (SU)<6mg/dL on allopurinol (n=2)/febuxostat (n=1)
Authors' conclusion
Rapid VMSU depletion during pegloticase therapy was observed with concomitant bone remodeling within 1year. Following pegloticase discontinuation, VMSU reduction slowed or stopped even when SU was maintained<6mg/dL with oral ULT.
Study context
- Population
- Patients with uncontrolled gout in the MIRROR RCT with paired baseline–Week 52 dual-energy CT (DECT) images; imaged regions with baseline VMSU<0.5cm3 excluded
- Participants
- 8 patients
- Comparison
- Pegloticase + methotrexate (MTX) vs pegloticase + placebo
- Pegloticase+MTXn = 6
- Pegloticase+pegloticase+placebo (PBO)n = 2reference
- Primary endpoint
- Monosodium-urate (MSU)-crystal volume (VMSU) and bone-erosion remodeling on DECT
- Follow-up
- Week 52
Methodological detailsexploratory, dual-energy CT substudy, placebo-controlled, Pegloticase therapy received: 52weeks (5 MTX), 42weeks (1 PBO), 6weeks (1 MTX, 1 PBO)
- Exploratory
- Dual-energy CT substudy
- Placebo-controlled
- Pegloticase therapy received: 52weeks (5 MTX), 42weeks (1 PBO), 6weeks (1 MTX, 1 PBO)
Primary result
As reported in the abstract
Bone-erosion remodeling in evaluated erosions
29 of 42
69%
Erosion size decrease
29
69%
Recortication
4
9.5%
New bone formation
3
7.1%
Original publication
Monosodium urate crystal depletion and bone erosion remodeling during pegloticase treatment in patients with uncontrolled gout: Exploratory dual-energy computed tomography findings from MIRROR RCT. Joint Bone Spine. Published 4 March 2024. doi:10.
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