Drug Interactions between coagulation factor ix and pegloticase

MONITOR: Antibodies that develop during pegloticase therapy may theoretically affect the pharmacologic effects of other pegylated agents. In clinical studies, anti-pegloticase antibodies developed in 92% of patients treated with pegloticase every 2 weeks, compared to 28% for placebo. Anti-PEG antibodies were also detected in 42% of patients treated with pegloticase. High anti-pegloticase antibody titer was associated with a failure to maintain pegloticase-induced normalization of uric acid. The impact of anti-PEG antibodies on the therapeutic response to other PEG-containing treatments is unknown. Because anti-pegloticase antibodies appear to bind to the PEG portion of the drug, there may be potential for binding with other pegylated products.

MANAGEMENT: Clinicians should be aware of the potential for diminished effects of other pegylated agents (including certain formulations of recombinant antihemophilic factor and coagulation factor IX as well as some liposomal formulations of chemotherapeutic agents such as doxorubicin and irinotecan) following treatment with pegloticase.