Persistent Uric Acid Reduction with Pegloticase May Lead To Reduced Liver Fibrosis Interview with:

Brian LaMoreaux, M.D., M.S. Medical Director, Medical Affairs Horizon Therapeutics

Dr. LaMoreaux

Brian LaMoreaux, M.D., M.S.
Medical Director, Medical Affairs
Horizon Therapeutics What is the background for this study?

Response: Hyperuricemia is associated with non-alcoholic fatty liver disease (NAFLD) but the relationship to fibrosis remains uncertain. Moreover, it is not known whether lowering serum urate will affect the course of NAFLD. What are the main findings?

Response: Based on a hypothesis that lowering urate in patients with chronic refractory gout might improve NAFLD, this analysis investigated whether treatment of chronic refractory gout patients with pegloticase was associated with improvement in NAFLD, as determined by Fibrosis 4 index (Fib4).

The results were consistent with the conclusion that persistent lowering of serum urate had a significant impact on Fib4 levels, implying a possible effect on the course of NAFLD. What should readers take away from your report?

Response: NAFLD is one of many potentially serious comorbidities associated with uncontrolled gout and this data showed that significant urate-lowering in uncontrolled gout patients could potentially provide a beneficial effect on hepatic fibrosis as measured through the FIB-4 score. What recommendations do you have for future research as a result of this work?

Response: The results support a more detailed evaluation of this topic involving liver imaging or even biopsy examination of the impact of profound urate lowering on liver inflammation and fibrosis.

Disclosures: I am a medical director at Horizon and a volunteer clinical rheumatologist with CommunityHealth. 

Citation EULAR 2020


  1. Schlesinger1, A. Yeo2P. Lipsky3

1Rutgers Robert Wood Johnson Medical School, New Brunswick, United States of America
2Horizon Therapeutics, Lake Forest, United States of America
3AMPEL BioSolutions, LLC, Charlottesville, United States of America


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Last Updated on June 15, 2020 by Marie Benz MD FAAD