Krystexxa Infusion Treatment for Uncontrolled Gout
TwelveStone Health Partners provides clinically monitored Krystexxa® (pegloticase) infusion treatment for adults with chronic gout that remains uncontrolled despite conventional therapy. Our team works directly with your prescribing rheumatologist to coordinate your treatment and provide ongoing clinical monitoring throughout your infusion care.
With more than 35 years of experience in community-based infusion care and 30+ private-suite locations across the Southeast, TwelveStone also coordinates prior authorization and benefits verification to help simplify your path to treatment.
How Krystexxa Infusion Treatment Works
Krystexxa (pegloticase) is an intravenous treatment for adults with chronic gout that remains uncontrolled despite conventional therapy. It is typically administered every two weeks and works by converting uric acid into allantoin, a water-soluble substance the body can eliminate more readily.
By lowering serum uric acid, Krystexxa can help reduce the urate crystal burden associated with uncontrolled gout. Treatment must be prescribed by an appropriate specialist and administered in a healthcare setting equipped to monitor for infusion reactions. At TwelveStone, patients receive their infusions in private suites with dedicated clinical monitoring and comfortable amenities.
Who Is Eligible for Krystexxa Infusion Treatment?
Who May Be a Candidate for Krystexxa?
Krystexxa may be an option for adults with chronic gout that remains uncontrolled despite conventional treatment or when standard urate-lowering medications are not clinically appropriate. Your prescribing specialist will review your treatment history, current health, and other clinical factors to determine whether Krystexxa is appropriate for you.
Krystexxa should not be given to patients with glucose-6-phosphate dehydrogenase (G6PD) deficiency because of the risk of serious blood-related complications. Patients at increased risk for G6PD deficiency should be screened before beginning treatment.
Why Methotrexate May Be Used With Krystexxa
Krystexxa is generally recommended with weekly methotrexate and folic acid or folinic acid supplementation. When used together, methotrexate can help reduce the development of anti-drug antibodies and improve the likelihood of maintaining a response to Krystexxa. If this combination is appropriate for you, methotrexate and folate supplementation are typically started at least four weeks before your first Krystexxa infusion.
Krystexxa can also be given without methotrexate when methotrexate is contraindicated or is not clinically appropriate. Your prescribing specialist will determine which treatment approach is appropriate based on your medical history and individual clinical needs.
Before treatment begins, make sure your prescribing specialist has a complete picture of your health and medications. Tell your care team about:
Your prescribing specialist will also review your gout medications, since oral urate-lowering drugs such as allopurinol, febuxostat, and probenecid are generally discontinued before starting Krystexxa and should not be used during treatment.
If your prescribing specialist determines that Krystexxa is appropriate for you, TwelveStone can coordinate with your provider and insurance plan to support prior authorization and benefits verification before treatment begins. Our team will help guide you through the next steps required to begin infusion care.
What to Expect During Krystexxa Infusion Treatment
Krystexxa is typically administered every two weeks at a TwelveStone infusion center, where your clinical team monitors you throughout treatment. The infusion itself lasts at least two hours, with additional time needed for premedications and post-infusion observation. Your serum uric acid level should also be checked before each infusion because rising levels can indicate loss of treatment response and an increased risk of infusion reactions.
If serum uric acid rises above 6 mg/dL, particularly on two consecutive measurements, your prescribing specialist will determine whether Krystexxa should be discontinued according to the treatment protocol.
Several safety measures are built into each Krystexxa infusion visit:
- Premedication: You receive an antihistamine and corticosteroid before the infusion to help reduce the risk of an infusion reaction.
- Clinical Monitoring: Your care team monitors you during the infusion and for an appropriate period afterward for signs of an infusion reaction or allergic reaction.
Gout flares can become more frequent when Krystexxa treatment begins as changing uric acid levels mobilize urate deposits. Your prescribing specialist may recommend gout flare prophylaxis before treatment and during the first several months of therapy. A gout flare does not necessarily mean that Krystexxa should be stopped; your specialist will determine how the flare should be managed.
Nausea and fatigue are among the adverse reactions that may occur with treatment. Because serious allergic and infusion reactions are also possible, seek immediate medical attention if symptoms such as hives, swelling, wheezing, or difficulty breathing develop during or after your infusion.
Preparing for Your Krystexxa Infusion Appointment
Before your Krystexxa infusion, follow any medication-specific instructions from your prescribing specialist and TwelveStone care team. Unless you are told otherwise, arrive well hydrated, eat normally, and wear comfortable clothing with loose or easily adjustable sleeves. Bring your photo ID, insurance card, and an up-to-date medication list. Plan to spend several hours at the infusion center, since your visit includes preparation, at least two hours for the infusion itself, and post-infusion monitoring.
Once you arrive, your visit generally includes these steps:
- Check-In and Clinical Review: Your care team confirms your information, checks your vital signs, and reviews required lab results, including your pre-infusion serum uric acid level.
- Infusion Preparation: A nurse establishes IV access and administers prescribed premedications, which typically include an antihistamine and corticosteroid to help reduce the risk of an infusion reaction.
- Infusion and Observation: Krystexxa is administered intravenously over at least two hours while your clinical team monitors you for reactions. You will remain under observation for an appropriate period after the infusion before you leave the center.
If your care team tells you that one of your premedications may cause drowsiness, arrange for someone to drive you home or discuss transportation options before your appointment.
Before leaving, your care team will provide any post-infusion instructions you need. If symptoms of a serious allergic reaction develop after you leave the center, seek immediate medical attention.
At TwelveStone, Krystexxa treatment takes place in private infusion suites designed for longer appointments, with comfortable recliners, WiFi, television, and refreshments available. With 30+ infusion centers across the Southeast, our team coordinates directly with prescribing providers to support continuity of care throughout treatment.
Frequently Asked Questions About Krystexxa Infusion Treatment
TwelveStone Health Partners can help coordinate the referral, benefits verification, prior authorization, and scheduling steps required to begin Krystexxa infusion care. If you have questions about treatment at TwelveStone or want to understand what is needed to get started, contact our team to speak with a care coordinator.
