Pegloticase (Krystexxa)

Covered: Krystexxa (pegloticase) is approved for adults (≥18) with chronic gout refractory to conventional therapy and is excluded in patients with G6PD deficiency and pediatric patients. Key requirements: documented symptomatic gout (≥3 flares in 18 months or ≥1 tophus/chronic gouty arthritis), intolerance/contraindication to or inadequate response to xanthine oxidase inhibitors (failure to lower uric acid <6 mg/dL after ≥3 months at max dose), premedication with antihistamine and corticosteroid, administration in a monitored setting with anaphylaxis preparedness, discontinuation of oral urate-lowering agents, serum uric acid monitoring (consider stopping if >6 mg/dL on consecutive tests), and authorization limited to 12 months.

"Krystexxa® (pegloticase) is indicated for the treatment of chronic gout in individuals refractory to conventional therapy."

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