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To evaluate the Certolizumab pegol (CZP) clinical advantages and harms among individuals with RA who have not responded well towards conventional disease-modifying anti-rheumatic drugs (DMARDs).
Tumour necrosis factor (TNF)-alpha receptor
plays a major role in the pathogeneisis of rheumatoid arthrirtis (RA).
Certolizumab pegol is a biological medication and a selective inhibitor of
TNF-alpha. In this cochrane review Ruiz Garcia V et al reported the significant improvement in the
progression of RA.
To evaluate the Certolizumab pegol (CZP) clinical
advantages and harms among individuals with RA who have not responded well
towards conventional disease-modifying anti-rheumatic drugs (DMARDs).
The ICTRP of WHO, CENTRAL, Web of Knowledge,
clinicaltrials.gov, MEDLINE, Embase, and reference lists of articles were
searched from 2014 to 26 September 2016.
A total of 14 trials involved in the analysis. Twelve involved
measures of benefit; investigators pooled 11 out of them. Further, 13 trials
comprised data regarding harms. The range of
Certolizumab pegol dose and duration of follow-up ranged from
subcutaneous 50 to 400 mg and 12 to 52 weeks, respectively. During Phase II
trials, the comparator was the only placebo and during Phase III trials, the
comparator was placebo in five and placebo plus MTX in seven trials. The 200 mg
Certolizumab pegol, the approved dose presented clinically significant
improvements at 24 weeks for the outcomes - American College of Rheumatology
(ACR) 50% improvement; The Health Assessment Questionnaire (HAQ); Proportion of
participants achieving remission (Disease Activity Score (DAS); Radiological
changes; and Serious adverse events (SAEs). A clinical notable rise in all
withdrawals in the placebo groups was seen due to the adverse events in the
Certolizumab groups. The estimation of the quality of evidence to be high for
ACR50, SAEs, withdrawals due to adverse events and DAS remission, and moderate for radiological
changes and HAQ. Due to inconsistency, the quality of evidence to be average
for all withdrawals.
The outcomes and conclusions did not change from the
prior review. There is a moderate to high evidence from that Certolizumab
pegol, alone or combination with Methotrexate is useful in the RA management.
Adverse effects were more prevalent with active therapy. The study discovered
clinically but not statistically meaningful risk of severe adverse effects.
Cochrane Database Syst Rev. 2017 Sep 8;9:CD007649
Certolizumab pegol (CDP870) for rheumatoid arthritis in adults.
Ruiz Garcia V et al.
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