Pegloticase Monitoring — SCE Rheumatology MCQ
Instant feedback + full explanation. One question, done properly.
Educational content. Not a substitute for clinical judgement or local policy.
Reveal the answer and explanation
Correct answer: A — Serum urate level must be checked before each infusion; a rising urate level indicates loss of efficacy from anti-drug antibodies and treatment should be stopped to avoid infusion reactions
Pegloticase (recombinant uricase) requires pre-infusion serum urate monitoring. A rising urate level before a scheduled infusion (>360 micromol/L) indicates development of anti-drug antibodies that neutralise the enzyme. Treatment should be discontinued as continued infusions in the presence of antibodies are ineffective and carry high risk of severe infusion reactions (anaphylaxis). Pre-medication with antihistamines and corticosteroids reduces but does not eliminate infusion reaction risk. Co-administration of immunosuppression (Methotrexate or Azathioprine) has been shown to reduce immunogenicity and maintain drug efficacy.
Reference: BSR 2017 gout guidelines; Sundy JS et al 2011 Pegloticase GOUT studies