{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:37:55Z","timestamp":1761061075731,"version":"3.44.0"},"reference-count":5,"publisher":"BMJ","issue":"6","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Case Rep"],"accepted":{"date-parts":[[2020,5,21]]},"published-print":{"date-parts":[[2020,6]]},"abstract":"<jats:p>Pegloticase is a highly effective treatment for refractory gouty arthropathy. Unfortunately, the medication is also highly immunogenic, leading to infusion reactions, loss of drug efficacy and anaphylaxis. Desensitisation, a procedure to tolerise a patient to a medication previously causing a hypersensitivity reaction, has been used successfully in oncology for chemotherapy treatment. The same principle can be applied to other specialties. Presented is a 48-year-old man who experienced multiple, severe infusion reactions to pegloticase administered for gouty arthropathy. A rapid desensitisation was performed using an outpatient, 3-bag, 12-step protocol, which allowed multiple additional pegloticase infusions to be performed without incident. This is the first reported case of a patient successfully desensitised after an infusion reaction to pegloticase. Though additional patients are needed to confirm these results, this represents a significant opportunity to recapture and continue pegloticase therapy in patients treated for refractory gouty arthropathy.<\/jats:p>","DOI":"10.1136\/bcr-2020-234721","type":"journal-article","created":{"date-parts":[[2020,6,22]],"date-time":"2020-06-22T02:35:29Z","timestamp":1592793329000},"page":"e234721","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":2,"title":["Pegloticase hypersensitivity desensitisation: an outpatient, 3-bag, 12-step protocol"],"prefix":"10.1136","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9552-3351","authenticated-orcid":false,"given":"John K","family":"Botson","sequence":"first","affiliation":[{"name":"Orthopedic Physicians Alaska, Anchorage, Alaska, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2020,6,21]]},"reference":[{"key":"2025082622451413000_13.6.e234721.1","unstructured":"Horizon . Krystexxa: highlights of prescribing information. Lake Forest, IL: Author, 2012."},{"key":"2025082622451413000_13.6.e234721.2","doi-asserted-by":"crossref","first-page":"119","DOI":"10.3349\/ymj.2019.60.2.119","article-title":"Desensitization for allergic reactions to chemotherapy","volume":"60","author":"Hong","year":"2019","journal-title":"Yonsei Med J"},{"key":"2025082622451413000_13.6.e234721.3","doi-asserted-by":"publisher","DOI":"10.1016\/j.ygyno.2004.08.002"},{"key":"2025082622451413000_13.6.e234721.4","doi-asserted-by":"crossref","unstructured":"Botson J , Peterson J . Pretreatment and co-administration with methotrexate improved durability of pegloticase response: a prospective, observational, proof of concept, case series [abstract]. EULAR European Congress of Rheumatology 2019.","DOI":"10.1136\/annrheumdis-2019-eular.3475"},{"key":"2025082622451413000_13.6.e234721.5","doi-asserted-by":"publisher","DOI":"10.1186\/ar4497"}],"container-title":["BMJ Case Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.1136\/bcr-2020-234721","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,8,27]],"date-time":"2025-08-27T05:45:24Z","timestamp":1756273524000},"score":1,"resource":{"primary":{"URL":"https:\/\/casereports.bmj.com\/lookup\/doi\/10.1136\/bcr-2020-234721"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,6]]},"references-count":5,"journal-issue":{"issue":"6","published-online":{"date-parts":[[2020,6,21]]},"published-print":{"date-parts":[[2020,6]]}},"alternative-id":["10.1136\/bcr-2020-234721"],"URL":"https:\/\/doi.org\/10.1136\/bcr-2020-234721","relation":{},"ISSN":["1757-790X"],"issn-type":[{"type":"electronic","value":"1757-790X"}],"subject":[],"published":{"date-parts":[[2020,6]]}}}