Certolizumab in the long-term treatment of rheumatoid arthritis

Abdul Khan, David L ScottDepartment of Rheumatology, King&rsquo;s College London School of Medicine, King&rsquo;s College, London, UKAbstract: Rheumatoid arthritis is the most common inflammatory arthritis and continues to have major long-term effects on quality of life. Early and in...

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Autores principales:	Scott DL, Khan A
Formato:	article
Lenguaje:	EN
Publicado:	Dove Medical Press 2011
Materias:	Diseases of the musculoskeletal system RC925-935
Acceso en línea:	https://doaj.org/article/a5c15b58862f4fe5852c903bd7b924fa
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spelling	oai:doaj.org-article:a5c15b58862f4fe5852c903bd7b924fa2021-12-02T05:14:45ZCertolizumab in the long-term treatment of rheumatoid arthritis1179-156Xhttps://doaj.org/article/a5c15b58862f4fe5852c903bd7b924fa2011-08-01T00:00:00Zhttp://www.dovepress.com/certolizumab-in-the-long-term-treatment-of-rheumatoid-arthritis-a8156https://doaj.org/toc/1179-156XAbdul Khan, David L ScottDepartment of Rheumatology, King&rsquo;s College London School of Medicine, King&rsquo;s College, London, UKAbstract: Rheumatoid arthritis is the most common inflammatory arthritis and continues to have major long-term effects on quality of life. Early and intensive treatment has now become the norm in clinical practice with changes of medication dictated by measuring the presence of continued disease activity. Biologics, particular tumor necrosis factor inhibitors, have a crucial role in the management of very severe disease. Certolizumab is a relatively new tumor necrosis factor inhibitor which uses a novel strategy to neutralize TNF-alpha &ndash; the conjugation of tumor necrosis factor specific Fab antibody fragments to polyethylene glycol. Two Phase II and three Phase III randomized controlled trials have evaluated the efficacy and toxicity of certolizumab. More than 2000 patients were enrolled, and followed from 12&ndash;52 weeks. The number of patients achieving significant improvements with certolizumab, was indicated by the American College of Rheumatology with a 50% response rate. The risk ratios of achieving this response at 24 weeks was 6.01 (95% confidence interval [CI]: 3.84&ndash;9.40). At 52 weeks the risk ratio was 5.27 (95% CI: 3.19&ndash;8.71). The number of patients needed to treat, to obtain this benefit at 24 weeks was 4 (95% CI: 3&ndash;5). Certolizumab also had important clinical benefits in reducing erosive damage to joints, limiting disability, and enhancing other outcomes of importance to patients such as fatigue. The patient-related benefits were present from the early weeks of treatment. The clinical trials showed serious adverse events, including infections, which were more frequent for certolizumab. The most common adverse events comprised upper respiratory tract infections, hypertension, and nasopharyngitis. The balance of evidence suggests that certolizumab is equivalent to other tumor necrosis factor inhibitors, though no head-to-head trials have been undertaken. Having several effective treatments available, benefits patient choice, because the frequency and route of administration of these treatments varies. Furthermore, as intolerance and antibody development against existing biologics is not uncommon, having several agents allows opportunities to switch from one inhibitor to another.Keywords: rheumatoid arthritis, certolizumab, anti-TNFScott DLKhan ADove Medical PressarticleDiseases of the musculoskeletal systemRC925-935ENOpen Access Rheumatology: Research and Reviews, Vol 2011, Iss default, Pp 63-71 (2011)
institution	DOAJ
collection	DOAJ
language	EN
topic	Diseases of the musculoskeletal system RC925-935
spellingShingle	Diseases of the musculoskeletal system RC925-935 Scott DL Khan A Certolizumab in the long-term treatment of rheumatoid arthritis
description	Abdul Khan, David L ScottDepartment of Rheumatology, King&rsquo;s College London School of Medicine, King&rsquo;s College, London, UKAbstract: Rheumatoid arthritis is the most common inflammatory arthritis and continues to have major long-term effects on quality of life. Early and intensive treatment has now become the norm in clinical practice with changes of medication dictated by measuring the presence of continued disease activity. Biologics, particular tumor necrosis factor inhibitors, have a crucial role in the management of very severe disease. Certolizumab is a relatively new tumor necrosis factor inhibitor which uses a novel strategy to neutralize TNF-alpha &ndash; the conjugation of tumor necrosis factor specific Fab antibody fragments to polyethylene glycol. Two Phase II and three Phase III randomized controlled trials have evaluated the efficacy and toxicity of certolizumab. More than 2000 patients were enrolled, and followed from 12&ndash;52 weeks. The number of patients achieving significant improvements with certolizumab, was indicated by the American College of Rheumatology with a 50% response rate. The risk ratios of achieving this response at 24 weeks was 6.01 (95% confidence interval [CI]: 3.84&ndash;9.40). At 52 weeks the risk ratio was 5.27 (95% CI: 3.19&ndash;8.71). The number of patients needed to treat, to obtain this benefit at 24 weeks was 4 (95% CI: 3&ndash;5). Certolizumab also had important clinical benefits in reducing erosive damage to joints, limiting disability, and enhancing other outcomes of importance to patients such as fatigue. The patient-related benefits were present from the early weeks of treatment. The clinical trials showed serious adverse events, including infections, which were more frequent for certolizumab. The most common adverse events comprised upper respiratory tract infections, hypertension, and nasopharyngitis. The balance of evidence suggests that certolizumab is equivalent to other tumor necrosis factor inhibitors, though no head-to-head trials have been undertaken. Having several effective treatments available, benefits patient choice, because the frequency and route of administration of these treatments varies. Furthermore, as intolerance and antibody development against existing biologics is not uncommon, having several agents allows opportunities to switch from one inhibitor to another.Keywords: rheumatoid arthritis, certolizumab, anti-TNF
format	article
author	Scott DL Khan A
author_facet	Scott DL Khan A
author_sort	Scott DL
title	Certolizumab in the long-term treatment of rheumatoid arthritis
title_short	Certolizumab in the long-term treatment of rheumatoid arthritis
title_full	Certolizumab in the long-term treatment of rheumatoid arthritis
title_fullStr	Certolizumab in the long-term treatment of rheumatoid arthritis
title_full_unstemmed	Certolizumab in the long-term treatment of rheumatoid arthritis
title_sort	certolizumab in the long-term treatment of rheumatoid arthritis
publisher	Dove Medical Press
publishDate	2011
url	https://doaj.org/article/a5c15b58862f4fe5852c903bd7b924fa
work_keys_str_mv	AT scottdl certolizumabinthelongtermtreatmentofrheumatoidarthritis AT khana certolizumabinthelongtermtreatmentofrheumatoidarthritis
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Certolizumab in the long-term treatment of rheumatoid arthritis

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