![Quantitative SERS Detection of Uric Acid via Formation of Precise Plasmonic Nanojunctions within Aggregates of Gold Nanoparticles and Cucurbit[n]uril](/_next/image?url=https%3A%2F%2Fcloudfront.jove.com%2FCDNSource%2Fteasers%2F61682.jpg&w=3840&q=50)
Updates in uricase therapy for gout
Naomi Schlesinger1, Dan Kaufmann2
1Harold J. Ardella T. and Helen T. Stevenson Presidential Chair in Rheumatology, Professor and Chief, Division of Rheumatology.
Current Opinion in Rheumatology
|September 8, 2025
Summary
Exogenous uricases are an option for gout patients unresponsive to oral urate-lowering therapy (ULT). Newer uricase therapies aim to reduce flares and infusion reactions by managing immune responses, improving gout treatment outcomes.
Area of Science:
- Rheumatology
- Pharmacology
- Immunology
Background:
- Urate-lowering therapy (ULT) is crucial for gout management.
- Some patients do not achieve target serum urate levels (< 6.8 mg/dL) with oral ULT.
- Exogenous uricases offer an alternative for refractory gout cases.
Purpose of the Study:
- To review available and emerging exogenous uricase therapies for gout.
- To focus on strategies for mitigating adverse effects like flares and infusion reactions.
- To discuss the role of immunomodulation and anti-inflammatory prophylaxis.
Main Methods:
- Literature review of current and investigational uricase treatments.
- Analysis of mechanisms underlying pegloticase limitations (gout flares, infusion reactions, antidrug antibodies).
- Exploration of novel uricase formulations and adjunctive therapies.
Main Results:
- Pegloticase is indicated for uncontrolled gout; rasburicase is for tumor lysis syndrome.
- Gout flares and infusion reactions with pegloticase are associated with antidrug antibodies.
- Emerging therapies like NASP and PRX-115 show potential for improved efficacy and tolerability.
Conclusions:
- Exogenous uricases are valuable for patients with uncontrolled gout.
- Immunomodulation and anti-inflammatory prophylaxis are key to reducing adverse events.
- Development of new uricases aims to enhance safety and effectiveness in gout management.
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