The answer, “Nowhere yet,” is probably not what you want to hear, but read on for the latest news.
Pegloticase is a generic name for PEG-uricase – a genetically engineered form of uricase. Uricase is an enzyme present in some animals that breaks down uric acid in the body. Humans do not produce uricase, so techniques have been developed to produce a type of uricase that humans can use.
Various versions of this treatment are being developed. The one that is most advanced is expected to be approved soon under the brand name Krystexxa, in the USA.
This was recommended for approval in June this year, and the FDA are expected to give final approval on August 1st.
So does this mean you can rush out and buy some in August?
Even when production gets up to speed, this is not a gout medication for self-administration. You need to go to your doctor, a clinic, or hospital for pegloticase to be given by intravenous infusion.
I suggest that you discuss this now with your doctor. There may be perfectly acceptable uric acid lowering therapies available to you. We have certainly discussed many other options in the gout forum, from the ubiquitous allopurinol to the newly launched febuxostat (Uloric / Adenuric). Surprisingly, even some blood pressure and cholesterol lowering medicines can have uric acid lowering effects.
If the discussion with your doctor reveals that you are a candidate for pegloticase, then he is in the best position to find a source of the medicine, or refer you to a suitable specialist. He may even know of clinical trials in your area, where you gain access to the treatment prior to it being on general release.
For latest information about pegloticase, please see Krystexxa (pegloticase) guidelines.