Name of the Procedure:

Injection, Pegloticase, 1 mg (J2507)

• Common Name: Pegloticase Injection
• Technical Term: Intravenous infusion of pegloticase

Summary

This procedure involves an intravenous injection of the medication pegloticase, which is used to lower uric acid levels in the blood.

Purpose

Pegloticase injection is primarily used to treat chronic gout in adults when other treatments have failed. The goal is to reduce uric acid levels and prevent gout flare-ups and joint damage.

Indications

• Chronic gout that is not controlled by other medications
• Elevated uric acid levels causing frequent gout attacks
• Patients who cannot tolerate other gout treatments

Preparation

• Patients may be advised to fast for a certain number of hours before the procedure.
• Blood tests may be conducted to assess uric acid levels and kidney function.
• All other medications and supplements should be reviewed with the healthcare provider.

Procedure Description

1. The patient is seated in a comfortable chair.
2. An intravenous (IV) line is established in the patient's arm.
3. Pegloticase is infused through the IV over a period of approximately 2 hours.
4. Vital signs are monitored throughout the infusion.
5. The IV line is removed once the infusion is complete.

Duration

The procedure typically takes about 2 hours.

Setting

This procedure is usually performed in a hospital outpatient clinic or an infusion center.

Personnel

• Registered Nurse (RN) to administer the infusion
• Healthcare provider (e.g., physician or nurse practitioner) to oversee the procedure
• Medical assistants may assist with pre-procedure preparation and monitoring

Risks and Complications

• Common Risks: Injection site reactions, headache, nausea
• Rare Risks: Severe allergic reactions, infusion reactions, anaphylaxis

Benefits

• Reduction in uric acid levels in the bloodstream
• Decrease in the frequency of gout attacks
• Prevention of joint damage associated with chronic gout
• Benefits are typically noticeable after a few treatment sessions

Recovery

• Patients are usually monitored for a short period after the infusion to ensure there are no immediate adverse reactions.
• Patients can typically resume normal activities shortly after the procedure.
• Follow-up appointments are necessary to monitor uric acid levels and evaluate the effectiveness of the treatment.

Alternatives

• Oral urate-lowering medications like allopurinol or febuxostat
• Dietary and lifestyle changes aimed at reducing uric acid levels
• Pros of Alternatives: Non-invasive, generally well-tolerated
• Cons of Alternatives: May not be effective in all patients, potential side effects

Patient Experience

• During the procedure, the patient may feel the initial prick from the IV insertion but generally should be comfortable.
• Some patients might experience mild discomfort at the infusion site.
• Pain management such as the use of acetaminophen or antihistamines may be provided if needed.
• Post-procedure, some patients may feel tired but can usually return to normal activities quickly.