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Krystexxa is a prescription PEGylated uric acid-specific enzyme containing pegloticase. It is indicated for chronic gout in adults whose uric acid and symptoms remain inadequately controlled with medically appropriate xanthine oxidase inhibitor treatment or who cannot use those medicines. It is not recommended for asymptomatic hyperuricemia.
read more about krystexxa ...Pegloticase is a recombinant uricase enzyme that converts uric acid to allantoin. Allantoin is water soluble and is readily eliminated, which lowers serum uric acid.
Krystexxa is used in adults with chronic gout refractory to conventional therapy. Patients at risk for glucose-6-phosphate dehydrogenase deficiency are screened before treatment, and Krystexxa is contraindicated in patients with this deficiency.
The recommended dose is 8 mg by intravenous infusion every two weeks with oral methotrexate 15 mg once weekly. Methotrexate with folic acid or folinic acid supplementation starts at least four weeks before Krystexxa and continues during treatment. Krystexxa alone can be used when methotrexate is contraindicated or not clinically appropriate.
Krystexxa carries boxed warnings for anaphylaxis, infusion reactions, and hemolysis or methemoglobinemia associated with glucose-6-phosphate dehydrogenase deficiency. Patients receive antihistamine and corticosteroid premedication, and the infusion lasts at least 120 minutes. Serum uric acid is checked before each infusion to identify loss of response and increased reaction risk.
Krystexxa treats chronic gout in adults who are refractory to conventional therapy.
The recommended dose is 8 mg by intravenous infusion every two weeks.
Yes. Current labeling recommends weekly oral methotrexate 15 mg unless methotrexate is contraindicated or not clinically appropriate.
Yes. The boxed warnings concern anaphylaxis, infusion reactions, and G6PD deficiency-associated hemolysis and methemoglobinemia.
DailyMed - KRYSTEXXA (pegloticase) injection, solution. https://dailymed.nlm.nih.gov/dailymed/drugInfo.cfm?setid=6e566303-d93a-4130-b764-25749829aa95. Date Accessed October 8, 2026.
KRYSTEXXA (pegloticase) Prescribing Information. Amgen. https://www.pi.amgen.com/united_states/Krystexxa/Krystexxa_fpi_english.pdf. Date Accessed October 8, 2026.
Pegloticase. MedlinePlus. https://www.medlineplus.gov/druginfo/meds/a611015.html. Date Accessed October 8, 2026.
Pegloticase. PubChem. https://pubchem.ncbi.nlm.nih.gov/compound/Pegloticase. Date Accessed October 8, 2026.
Pegloticase. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK572054/. Date Accessed October 8, 2026.