Impact of pegloticase on cardiovascular function in young-onset Type 2 Diabetes

Motivation: Increasing prevalence of youth-onset type 2 diabetes (T2D) is a global concern and characterized by a higher risk for hyperuricemia, a strong risk factor for cardiovascular disease (CVD). Goal(s): Studies have shown that serum uric acid (SUA) lowering in the general population may confer cardiovascular protection, but there have been no studies on its effectiveness in young adults with T2D. Approach: Here, we hypothesized aggressive SUA lowering using single intravenous infusion dose of the uricase, pegloticase, will attenuate cardiac magnetic resonance imaging (CMR) markers of CVD in young adults with T2D. Results: Unexpectedly, we documented impaired CMR-based global longitudinal strain after pegloticase infusion. Impact: Our study demonstrates the impacts of a drug therapy to reduce serum uric acid in youth-onset T2D and its impact on cardiovascular function using CMR. A comprehensive examination of the cardiovascular effects of the therapy is required for youth-onset T2D.