Serum urate (SU) responders to pegloticase experienced significant reductions in mean arterial pressure (MAP) that were independent of changes in renal function, according to prior randomized clinical trials (RCTs). To determine the impact of persistent, very low SU on blood pressure (BP) in patients with chronic refractory gout, investigators used results from two 6-month RCTs in which patients were treated with 8 mg pegloticase every 2-4 weeks (q2 or q4) or placebo. SU responders maintained SU at less than 6 mg/dL. Sitting BP was measured at each visit, and eGFR was determined at baseline and after 3 and 6 months. Serial BP measures were obtained in 173 patients during the RCTs. The researchers noted significant reductions in mean MAP from baseline to 6 months in q2 responders, whereas reductions in mean MAP in other groups were not significant. Notably, 62.1% of q2 SU responders experienced persistent reductions in MAP. Of the q2 SU responders exhibiting persistent decreases in MAP, no significant differences were observed in baseline age, gender, race, BMI, history of hypertension, gout duration, MAP, SU, cholesterol, eGFR or uric acid/creatinine ratio compared with those who did not lower MAP. There were no significant changes in eGFR in SU responders to pegloticase treatment during the study and there was no significant correlation between change from baseline MAP and eGFR in these patients.
