Author Interviews, Gout / 27.06.2025
EULAR 2025: Monthly KRYSTEXXA with MTX Matched Safety & Efficacy of Biweekly treatment for Uncontrolled Gout
MedicalResearch.com Interview with:
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Dr. Troum[/caption]
Orrin M. Troum, MD
Orrin M. Troum, MD, is a Clinical Professor of Medicine and
Voluntary Faculty Member of the Division of Rheumatology
Keck School of Medicine- UCLA
Director, Clinical Rheumatology Research
Providence St John's Hospital
Santa Monica, California
MedicalResearch.com: What is the background for this study? Who is more likely to develop uncontrolled gout?
Response: The Phase 4, open-label FORWARD trial was designed to evaluate the safety and efficacy of less frequent, monthly dosing of KRYSTEXXA® (pegloticase) co-administered with methotrexate (MTX) in patients with uncontrolled gout. KRYSTEXXA remains the only FDA-approved therapy for this challenging condition, but with continued research like the FORWARD trial, we can further improve and evolve the treatment landscape for patients. This study reflects a broader effort to optimize gout care with approaches that are not only effective but also more sustainable in real-world settings.
Uncontrolled gout happens when gout is not properly treated and uric acid levels continue to rise, which can have a damaging impact on the body beyond the pain of regular flares. Those experiencing uncontrolled gout continue to have signs and symptoms of gout despite taking oral urate-lowering medicines.
Dr. Troum[/caption]
Orrin M. Troum, MD
Orrin M. Troum, MD, is a Clinical Professor of Medicine and
Voluntary Faculty Member of the Division of Rheumatology
Keck School of Medicine- UCLA
Director, Clinical Rheumatology Research
Providence St John's Hospital
Santa Monica, California
MedicalResearch.com: What is the background for this study? Who is more likely to develop uncontrolled gout?
Response: The Phase 4, open-label FORWARD trial was designed to evaluate the safety and efficacy of less frequent, monthly dosing of KRYSTEXXA® (pegloticase) co-administered with methotrexate (MTX) in patients with uncontrolled gout. KRYSTEXXA remains the only FDA-approved therapy for this challenging condition, but with continued research like the FORWARD trial, we can further improve and evolve the treatment landscape for patients. This study reflects a broader effort to optimize gout care with approaches that are not only effective but also more sustainable in real-world settings.
Uncontrolled gout happens when gout is not properly treated and uric acid levels continue to rise, which can have a damaging impact on the body beyond the pain of regular flares. Those experiencing uncontrolled gout continue to have signs and symptoms of gout despite taking oral urate-lowering medicines.
Dr. Lopes[/caption]
Gilberto Lopes, M.D.
Professor, Chief, Division of Medical Oncology
Associate Director for the Cancer Center and
Medical Director for International Affairs
Sylvester Comprehensive Cancer Center
MedicalResearch.com: What is the background for this study?
Response: There is growing evidence linking alcohol consumption to increased cancer risk and mortality. This association was recently emphasized by the former U.S. Surgeon General, prompting renewed public health interest. In response to these concerns, under the mentorship of Dr. Lopes, we evaluated national trends in alcohol-associated cancer mortality using data from the Global Burden of Disease database.
Source[/caption]
Pexels image[/caption]
Dr. Piper[/caption]
Brian J. Piper, PhD
Department of Medical Education
Center for Pharmacy Innovation & Outcomes
Geisinger College of Health Sciences
Scranton, PA 18509
MedicalResearch.com: What is the background for this study?
Dr. Piper: Tapentadol has an unusual mechanism of action. This opioid is similar to morphine in that it activates mu, the main opiate receptor which is important for pain. This drug also acts similar to an antidepressant like duloxetine (Cymbalta) with equal ability to block both the norepinephrine and the serotonin transporters (Figure 1). The combination of opioid and monoaminergic activity may influence both therapeutic and side effect profiles.
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Figure 1. Biological mechanism of action of the atypical opioid tapentadol involves binding to the mu opiate receptor, blocking the norepinephrine transporter (NET), and blocking the serotonin transporter (SERT) [1].[/caption]Tapentadol is approved in the US for moderate to severe acute pain, moderate to severe chronic pain, and neuropathic pain associated with diabetic peripheral neuropathy. However, tapentadol is not generally considered first-line for any of these indications. Although this agent has a high potential for abuse and is classified as a Schedule II substance, a manufacturer of extended release tapentadol (Grunenthal) has conducted a misinformation campaign claiming tapentadol has a “minimum potential of abuse”, does not cause respiratory depression (a well-known opioid effect), does not cause any euphoric feelings, has no street value, and is not an opioid [2]. Prior pharmacoepidemiological studies have examined the use patterns of other prescription opioids that can be misused like oxycodone [3], fentanyl [4], meperidine [5] and methadone [6] but there is limited national information about the use of tapentadol.