title: Certolizumab pegol  for the treatment of rheumatoid arthritis.
abstract: BACKGROUND
  Improved understanding of the pathogenesis of rheumatoid arthritis (RA), and subsequent development of targeted therapies, have greatly advanced the management of this chronic inflammatory disease. The aim of treatment is a state of clinical remission. Certolizumab pegol (CZP) is a novel pegylated TNF alpha inhibitor (TNFi) therapy and is the focus of this review.
  
  
  METHODS
  CZP is different from other TNFi as it contains a polyethylene glycol (PEG) moiety, and lacks the constant fragment (Fc) of immunoglobulin; therefore it does not activate complement. In this review in addition to clinical efficacy of CZP, effects on radiographic and patient-reported outcomes, are discussed. Adverse event data from clinical trials and extension studies are also reviewed.
  
  
  CONCLUSIONS
  The addition of novel TNFi therapies to treat RA is welcomed. As well as displaying clinical efficacy, there is evidence to suggest that CZP has unique characteristics, including reduced transfer across the placenta and reduced frequency of injection site reactions. Furthermore, randomised controlled trials (RCTs) of CZP have demonstrated rapid improvements in workplace and home productivity in patients contributing to reducing the significant socioeconomic burden of RA.
authors.affiliation: Division of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.
authors.forename: Sarah
authors.initials: S
authors.lastname: Horton
authors.forename: Ceara
authors.initials: C
authors.lastname: Walsh
authors.forename: Paul
authors.initials: P
authors.lastname: Emery
mesh_terms: D000818:Animals; D061067:Antibodies, Monoclonal, Humanized / Q000493:pharmacokinetics / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000493:pharmacokinetics / Q000627:therapeutic use*; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000276:immunology / Q000378:metabolism; D000068582:Certolizumab Pegol; D017326:Clinical Trials, Phase III as Topic / Q000379:methods; D006801:Humans; D007140:Immunoglobulin Fab Fragments / Q000627:therapeutic use*; D011092:Polyethylene Glycols / Q000493:pharmacokinetics / Q000627:therapeutic use*; D016896:Treatment Outcome; D014409:Tumor Necrosis Factor-alpha / Q000037:antagonists & inhibitors / Q000276:immunology / Q000378:metabolism
chemical_list: D061067:Antibodies, Monoclonal, Humanized; D018501:Antirheumatic Agents; D007140:Immunoglobulin Fab Fragments; D014409:Tumor Necrosis Factor-alpha; D011092:Polyethylene Glycols; D000068582:Certolizumab Pegol