AB1057 EFFICACY AND SAFETY OF LOW-DOSE RASBURICASE IN COMBINATION WITH CONVENTIONAL URATE-LOWERING THERAPY FOR REFRACTORY CHRONIC GOUTY ARTHRITIS: A PILOT STUDY IN

Background Recombinant uricase such as pegloticase are indicated for chronic gouty arthritis who have failed to achieve serum urate level <300?mol/L even though receiving conventional urate-lowering drugs. Rasburicase which is currently approved at a dosage of 0.2 mg/(kg.d) 5 days the prevention tumor lysis syndrome in pediatric patients with hematological tumors, only available China present. Objectives To evaluate efficacy and safety low-dose rasburicase refractory arthritis. Methods We retrospectively collected data 17 were treated from January 2021 September Sun Yat-sen Memorial Hospital, University. The was defined still more than 300?mol/L dual-energy CT showed volume 10 cm 3 , allopurinol, febuxostat, and/or benzbromarone maximum tolerable amount received months. added every four weeks (week 0, week 4, 8) 1.5 mg/d three consecutive days, on basis daily oral drugs amount. monitored. primary outcome change 12 compared 0 by CT. Results ? Seventeen recruited 16 males (94%) mean age 47±15 years old. median gout course 11 (6.5, 15) flares number 20 (11, 36) times previous year. At before add-on treatment, 652±94?mol/L 44 (21, 215) (Table 1). ? Urate after treatment significantly decreased that either or 8 (Figure 1A, all p < 0.001). reduction 565 (446, 621) 214 (57, 373) 8, 118 185) (all <0.017). Five cases (29%) lower 12. ? 1B~D). 24 (12, 60) ( <0.001) percentage 42% (25%, 66%). positively correlated baseline r =0.890, <0.001), while negatively =-0.689, =0.002). ? generally well tolerated. No attack occurred intravenous methylprednisone 20mg each colchicine 0.5mg/d 1mg/d. hypersensitive reaction during treatment. Phlebitis patient (6%), dizziness nausea two (13%). One (6%) suffering kidney disease stage developed acute injury injection but creatinine spontaneously returned follow-up. Figure 1. A: Paired comparison time administration; B. Reduction value patient. C&D: Dual-energy (DECT) dramatical (C, volume: 72.15 cm3) (D, 7.66 cm3). ***: p< 0.001; #: Received only; ##&###: 7.5mg 0. Conclusion This pilot study shows tolerated may be reasonable option effectively burden these patients, although this an off-label use. Further prospective randomized controlled studies verify needed. Funding funded Clinical Research Project. Disclosure Interests None declared