Cimzia (certolizumab pegol)
Certolizumab pegol is a type of biologic therapy that can be used to treat certain adults with moderate-to-severe Crohn's disease (CD), one of the two main forms of inflammatory bowel disease.1,3 It is usually prescribed for people who have not experienced enough relief of their symptoms from the more common treatments for CD, such as immunosuppressants.
Certolizumab pegol is sold in the United States under the brand name Cimzia. Patients take certolizumab pegol through an injection: usually, two injections every two weeks for the first four weeks of treatment. At that point, if the patient is responding to the treatment, then the following injections are given once every four weeks. In some cases the patient will be shown how to self-administer the injections, and in other cases the injections will be administered by a healthcare professional or by someone who the patient lives with and/or feels comfortable.
How does certolizumab pegol work?
Certolizumab pegol is a type of biologic therapy known as an anti-tumor necrosis factor (anti-TNF), which contains special organic antibodies created in a laboratory.1,2 These antibodies work by seeking out and blocking the effect of the proteins in the body called “cytokines” that are responsible for controlling the level of inflammation. When the body is fighting off an infection, for example, the cytokines produced by the immune system can increase the amount of inflammation to fight off the infection. People with inflammatory bowel disease, including CD, may have too much inflammation in their digestive tracts, which causes their symptoms.
By targeting a specific cytokine called “tumor necrosis factor alpha” and affecting the way it causes inflammation, the antibodies in certolizumab pegol can help to reduce inflammation and relieve symptoms. Certolizumab pegol is different than other types of anti-TNF drugs used to treat CD, such as infliximab (brand name: Remicade) and adalimumab (brand name: Humira). In certolizumab pegol, the antibody in the drug is combined with a substance that helps it to stay in the body longer before it is excreted.
For many people with moderate or severe CD, certolizumab pegol can help to reduce their symptoms and help them to stay in remission for a longer time.
Who can take certolizumab pegol?
In the United States, certolizumab pegol is approved for use in adults with moderate to severe CD who have not had a good response to prior treatment options. Certolizumab pegol is also approved as a treatment for adults with active psoriatic arthritis, moderate to severe rheumatoid arthritis, and ankylosing spondylitis.3
Before starting treatment with certolizumab pegol, healthcare providers need to know about any medications or supplements that a patient is taking, as well as if women are pregnant, planning to become pregnant or breastfeeding. People taking certolizumab pegol cannot receive live vaccines during treatment. Patients will be tested for TB before starting treatment.3
Because of the effect that certolizumab pegol has on a person’s immune system, people who currently have an infection or infectious disease may not be able to start treatment with certolizumab pegol until the infection is gone. Healthcare providers will also ask patients if they tend to get frequent or recurring infections, or if they have or have ever had:3
- Immune system conditions
- Hepatitis B
- Any type of cancer
- Congestive heart failure
- Any nervous system disorder, such as seizures or multiple sclerosis
What side effects can taking certolizumab pegol cause?
The most common side effects linked to treatment with certolizumab pegol include upper respiratory infections, rash, and urinary tract or bladder infections.3
In a small number of patients, taking certolizumab pegol can potentially cause some very serious side effects. Because certolizumab pegol lowers the body’s immune system response, people taking it can be more likely to get infections and have harder time fighting them off if they do. These can include serious viral, bacterial, and fungal infections, such as tuberculosis or hepatitis B.3
Healthcare providers will monitor patients carefully for signs of infection or other potentially serious side effects, including:3
- Heart failure
- Allergic reactions
- Nervous system problems
- Blood problems
- Immune system problems
- Certain types of cancers
These are not all the possible side effects of certolizumab pegol. Patients should talk to their doctor about what to expect with treatment with certolizumab pegol.