This is a Phase 4, multicenter, open-label, single-arm observational study of KRYSTEXXA 8 mg i.v. every 2 weeks in adult hyperuricemic patients with gout refractory to conventional therapy. Approximately 1500 patients will be enrolled in order to observe treatment of up to 500 patients at approximately 300 centers in the United States (US). Study duration is approximately 63 weeks, including 51 weeks of treatment and 12 weeks of follow-up. The proposed patient number and 1 year duration of the study will significantly extend the patient exposure to KRYSTEXXA compared with the pre-marketing controlled clinical trials.