Evidence map›Paper›PMID 41629465›Full record

ReviewDrugs2026

Nanoencapsulated Sirolimus Plus Pegadricase (NASP) in Uncontrolled Gout: Current Status and Future Directions.

Herbert S B Baraf, Naomi Schlesinger, Vibeke Strand

Abstract readReview
In one paragraph

Review in Drugs, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

1 citing paper in PubMed.

  1. Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

3 authors.

Herbert S B BarafRheumatology, The George Washington University, Washington, DC, USA. hsbbaraf@mac.com.ORCID http://orcid.org/0000-0002-0162-9930
Naomi SchlesingerDivision of Rheumatology, Department of Medicine, Spencer Fox Eccles School of Medicine, University of Utah, Salt Lake City, UT, USA.ORCID http://orcid.org/0000-0002-1558-1202
Vibeke StrandDivision of Immunology/Rheumatology, Stanford University School of Medicine, Palo Alto, CA, USA.ORCID http://orcid.org/0000-0003-4978-4072

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Uncontrolled gout (UG) is a progressive arthropathy that develops as a consequence of sustained hyperuricemia. Recombinant uricases can profoundly lower serum urate (SU) and reverse the clinical manifestations of uncontrolled gout. However, therapeutic uricases are highly immunogenic and can provoke the development of anti-drug antibodies (ADAs), resulting in a loss of effect and potentially severe allergic reactions. Pegloticase is currently the only US Food and Drug Administration-approved uricase indicated for the treatment of UG. The Food and Drug Administration recently approved the co-administration of methotrexate with pegloticase to inhibit ADA formation and enhance the efficacy and tolerability of pegloticase. Nanoencapsulated sirolimus plus pegadricase (NASP) is a novel every-4-week treatment delivered as a sequential two-component infusion consisting of nanoencapsulated sirolimus immediately followed by pegadricase, a novel PEGylated uricase. NASP mitigates ADA formation by promoting uricase-specific immunotolerance, thereby obviating the need for systemic immunomodulatory drugs. Phase I trials demonstrated that NASP inhibited ADA development, allowing sustained pegadricase control and SU lowering for up to 30 days. The dose-finding (phase II) study showed NASP (nanoencapsulated sirolimus 0.1-0.15 mg/kg and pegadricase 0.2 mg/kg) reduced ADA development and supported durable SU lowering. The phase II COMPARE trial demonstrated that monthly NASP was as effective as twice-monthly pegloticase in achieving SU targets at 6 months. Combined phase III DISSOLVE trial data confirmed that NASP significantly lowered SU and increased SU responses in participants with UG. All phase I-III trials demonstrated that NASP was generally well tolerated with no specific safety signals. Overall, NASP has demonstrated robust and durable SU lowering, which ultimately reduced disease burden, supporting positive health-related quality-of-life outcomes. This review summarizes the clinical development of NASP with particular reference to the targeted immunotolerizing strategy that diminishes its immunogenicity. Video abstract available online. Video Abstract.

Indexed as

GoutGout SuppressantsPolyethylene GlycolsSirolimusUrate OxidaseAnimalsHumansGout SuppressantsPegloticasePolyethylene GlycolsSirolimusUrate Oxidase

Identifiers

PMID41629465
PMCPMC12963115

What Socratic holds

Textmetadata
LicenceCC BY-NC
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.