Prefilled certolizumab pegol (Cimzia^®) syringes for self-use in the treatment of rheumatoid arthritis

J Rosa^1,2, M Sabelli^1,2, Enrique R Soriano^1,2
1Rheumatology Section, Internal Medical Services, Hospital Italiano de Buenos Aires, and Fundacion P.M. Catoggio para el progreso de la Reumatologia; ²University Institute, School of Medicine, Hospital Italiano de Buenos Aires, Argentina

Abstract: A new anti-tumor necrosis factor alpha (TNF-a) inhibitor with a novel mechanism of action has entered phase 3 trials in rheumatoid arthritis (RA). Certolizumab pegol (Cimzia^®) is a humanized Fab' antibody fragment against TNF-a with a polyethylene glycol tail that prevents complement-dependent and antibody-dependent cell-mediated cytotoxicity or apoptosis. Four randomized clinical trials have been published so far. Reported results are similar to those published in previous studies with other TNF-a inhibitors, with ACR20, ACR50, and ACR70 responses of around 60%, 40%, and 20%, respectively, when combined with methotrexate and slightly lower when used as monotherapy. Safety was shown to be similar to that seen with TNF-a blockers and some cases of tuberculosis were seen in the trials, stressing the importance of a complete screening in these patients. Although we still need effectiveness and safety data in larger numbers of patients and longer follow-up, this new TNF inhibitor is a welcome addition to our current armamentarium for the treatment of RA.

Keywords: certolizumab pegol, rheumatoid arthritis therapy, biologic therapies