b'B:16"T:15.75"S:14.75"KRYSTEXXA is the only treatment indicated for uncontrolled gout 1,2 SEE THE RESULTSKRYSTEXXA with methotrexateAvailable soon through the VAs Pharmaceutical Prime Vendor,McKessonKRYSTEXXA CO-ADMINISTRATION WITH METHOTREXATE SHOWED A 74% RELATIVE IMPROVEMENT IN COMPLETE TOPHI RESOLUTION VS KRYSTEXXA ALONE 1KRYSTEXXA co-administered with methotrexate* provided IMPROVED EFFICACYand REDUCED RISK OF INFUSION REACTIONSvs KRYSTEXXA alone 1 Improved ecacy: 80% relative improvement in patient response; 71% (71/100) vs 39% (20/52) sUA-lowering response compared to KRYSTEXXA alone during Month 6 1 Reduced risk of infusion reactions: 87% relative reduction in infusion reactions; 4% (4/96) vs 31% (15/49) compared to KRYSTEXXA alone 1Baseline Week 52 Baseline Week 52Photos from a patient in the MIRROR trial.Discover how KRYSTEXXA with methotrexate canThe optimal treatment duration has not been established.1 Individual results may vary.help your VA patients at KRYSTEXXAhcp.comSecondary endpoint: complete tophi resolution 3QD, every day; QW, weekly; Q2W, every 2 weeks; sUA, serum uric acid; VA, Veterans A airs.54% (28/52) of patients in the KRYSTEXXA with methotrexate group and 31% (9/29) of patients inS:9.75" T:10.75" B:11"Study design: a 52-week, randomized, double-blind trial conducted in adult patients with chronic gout refractory to conventional therapythe KRYSTEXXA alone group achieved a complete response at Month 12 1to evaluate administration of 8 mg KRYSTEXXA Q2W co-administered with 15 mg oral methotrexate QW and 1 mg oral folic acid QD vs KRYSTEXXA alone.1 De ned as 100% resolution of at least 1 target tophus, no new tophi appearing, and no single *KRYSTEXXA alone may be used in patients for whom methotrexate is contraindicated or not clinically appropriate.1 tophus showing progression 1sUA-lowering response: the primary ecacy endpoint was the proportion of responders, de ned as patients achieving and maintainingsUA levels 6 mg/dL for at least 80% of the time during Month 6.1 Among patients with digital photography of tophi at baseline (53.3% of patients [81/152]).1INDICATION WARNINGS AND PRECAUTIONS ADVERSE REACTIONSKRYSTEXXA (pegloticase) is indicated for theproviders prepared to manage anaphylaxisGout Flares: An increase in goutares isThe most commonly reported adverse reactions treatment of chronic gout in adult patients whoand infusion reactions. frequently observed upon initiation of anti- (5%) are:have failed to normalize serum uric acid andPremedicate with antihistamines andhyperuricemic therapy, including KRYSTEXXA.KRYSTEXXA co-administration with whose signs and symptoms are inadequatelycorticosteroids and closely monitor forGoutare prophylaxis with a non-steroidalmethotrexate trial:controlled with xanthine oxidase inhibitors atanaphylaxis for an appropriate periodanti-in ammatory drug (NSAID) or colchicineKRYSTEXXA with methotrexate: goutares, the maximum medically appropriate dose or forafter administration of KRYSTEXXA. is recommended starting at least 1 weekarthralgia, COVID-19, nausea, and fatigue;Monitor serum uric acid levels prior to eachbefore initiation of KRYSTEXXA therapy and whom these drugs are contraindicated. KRYSTEXXA alone: goutares, arthralgia, Limitations of Use: KRYSTEXXA is not recommendedinfusion and discontinue treatment if levelslasting at least 6 months, unless medicallyCOVID-19, nausea, fatigue, infusion reaction, for the treatment of asymptomatic hyperuricemia. increase to above 6 mg/dL, particularlycontraindicated or not tolerated. pain in extremity, hypertension, and vomiting.IMPORTANT SAFETY INFORMATION when 2 consecutive levels above 6 mg/dLCongestive Heart Failure: KRYSTEXXA hasKRYSTEXXA pre-marketing placebo-are observed. not been formally studied in patients withcontrolled trials:WARNING: ANAPHYLAXIS AND INFUSIONScreen patients at risk for glucose-6- congestive heart failure, but some patients in thegoutares, infusion reactions, nausea, contusion REACTIONS, G6PD DEFICIENCY ASSOCIATEDphosphate dehydrogenase (G6PD) de ciencypre-marketing placebo-controlled clinical trialsor ecchymosis, nasopharyngitis, constipation, HEMOLYSIS AND METHEMOGLOBINEMIA prior to starting KRYSTEXXA. Hemolysis andexperienced exacerbation. Exercise caution inchest pain, anaphylaxis, and vomiting. Anaphylaxis and infusion reactions havemethemoglobinemia have been reportedpatients who have congestive heart failure and with KRYSTEXXA in patients with G6PDPlease see Brief Summary of Prescribing been reported to occur during and afterde ciency. KRYSTEXXA is contraindicated inmonitor patients closely following infusion.administration of KRYSTEXXA. patients with G6PD de ciency. Information, including Boxed Warning, forAnaphylaxis may occur with any infusion,KRYSTEXXA on the following pages.including arst infusion, and generallyCONTRAINDICATIONS: manifests within 2 hours of the infusion.References: 1. KRYSTEXXA (pegloticase) [prescribing information] Horizon. 2. FDA approves KRYSTEXXA(TM) (pegloticase) for the treatment of chronicI n patients with G6PD de ciency. gout in adult patients refractory to conventional therapy. Fierce Biotech. September 15, 2010. Accessed May 12, 2023. https://www. ercebiotech.com/Delayed hypersensitivity reactions haveIn patients with history of serious hypersensitivitybiotech/fda-approves-krystexxa-tm-pegloticase-for-treatment-of-chronic-gout-adult-patients 3. Botson JK, et al. Arthritis Rheumatol. 2023;75:293-304.also been reported. reactions, including anaphylaxis, to KRYSTEXXA KRYSTEXXA should be administered inor any of its components.healthcare settings and by healthcare 2024 Amgen Inc. All rights reserved. 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