What are the effects of certolizumab in rheumatoid arthritis (RA)?

Updated: Feb 07, 2020
  • Author: Howard R Smith, MD; Chief Editor: Herbert S Diamond, MD  more...
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Fleischmann et al found that monotherapy with certolizumab effectively reduced the signs and symptoms of active RA in patients in whom DMARD therapy had failed. [85] In this study, 200 patients were randomized on a 1:1 basis to receive certolizumab 400 mg or placebo every 4 weeks for 24 weeks. At 24 weeks, 45.5% of the certolizumab group achieved a 20% improvement, according to ACR criteria, compared with 9.3% of the placebo group. Statistically significant differences were observed as early as week 1 through week 24. [85]

A study by Smolen et al found that certolizumab plus MTX was more efficacious than placebo plus MTX, rapidly and significantly improving signs and symptoms of RA and physical function and inhibiting radiographic progression. [86] In this study, 619 patients were randomized to receive certolizumab 400 mg at weeks 0, 2, and 4, followed by 200 mg or 400 mg plus MTX every 2 weeks or placebo plus MTX every 2 weeks.

Significantly more patients who received certolizumab 200 mg (57.3%) or 400 mg (57.6%) achieved 20% improvement by ACR criteria than did those who received placebo (8.7%). [86] Radiographic progression was significantly inhibited with certolizumab 200 mg or 400 mg, as compared with placebo. When compared with placebo plus MTX, certolizumab plus MTX significantly relieved signs and symptoms, improved physical function, and inhibited radiographic progression in patients with RA. [86]


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