27 Jun EULAR 2025: Monthly KRYSTEXXA with MTX Matched Safety & Efficacy of Biweekly treatment for Uncontrolled Gout
MedicalResearch.com Interview with:
Dr. Troum
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.
MedicalResearch.com: What are the main findings?
Response: Data from the FORWARD trial demonstrate that monthly dosing of KRYSTEXXA with MTX every 4 weeks maintained a safety and efficacy profile comparable to the current FDA-approved biweekly regimen established in the MIRROR randomized control trial.
At 6 months, 68–73% of patients with uncontrolled gout achieved a serum urate–lowering response, with similar efficacy sustained at 12 months. Additionally, patients maintained target uric acid levels for a median time of 100% over both 24- and 48-week periods following the first infusion, underscoring the durability of response.
MedicalResearch.com: What should readers take away from your report?
Response: Findings from the FORWARD trial underscore the feasibility of a more efficient treatment regimen for patients with uncontrolled gout—demonstrating that reduced dosing frequency can maintain the strong outcomes we’ve come to expect from KRYSTEXXA in current clinical practice over the nearly 15 years since it’s been approved. Importantly, this evolution in care does not compromise efficacy or safety.
Increased treatment efficiency gives patients meaningful time back – less time in the clinic can translate to greater flexibility in managing their health and daily lives. At the same time, this approach can drive improved adherence and help more patients benefit from care while offering tangible benefits for providers, easing logistical demands and enhancing workflow.
As the robust evidence base around KRYSTEXXA continues to grow, these data further solidify its role as a cornerstone in the management of uncontrolled gout and reflect our ongoing commitment to evolving gout care in ways that are both clinically impactful and practically sustainable.
MedicalResearch.com: What recommendations do you have for future research as a results of this study?
Response: Though gout has historically not been something studied at length, and is still often underappreciated as a disease, continued research brings new engagement to understanding the full patient impact and more importantly ways to help improve outcomes and return patients to their activities of daily living.
Relevant disclosures for Troum include AbbVie/Abbott, Amgen, Bristol-Myers Squibb, Eli Lilly, Genentech, GlaxoSmithKlein, Novartis, Roche, and UCB.
Citation: EULAR 2025 Abstract Scientific Abstracts Poster View VIII
Safety and Efficacy of Monthly Dosing of Pegloticase (Every 4 Weeks) With Methotrexate Co-administration in Patients With Uncontrolled Gout: Phase 4 FORWARD Open-label Trial
Troum, J. Botson, F. Fang, K. Obermeyer, A. Mohammad, S. Verma, B. LaMoreaux,
Annals of the Rheumatic Diseases, Volume 84, Supplement 1, 2025, Pages 1225-1226, ISSN 0003-4967,
https://doi.org/10.1016/j.ard.2025.06.503
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Last Updated on June 27, 2025 by Marie Benz MD FAAD
