title: The efficacy and safety of certolizumab pegol (CZP) in the treatment of active rheumatoid arthritis (RA): a meta-analysis from nine randomized controlled trials.
abstract: OBJECTIVE
  Certolizumab pegol (CZP) is a novel anti-TNF agent that is used for patients with moderate to severe active rheumatoid arthritis (RA). However, the efficacy of CZP in RA remains controversial. Thus, we performed this meta-analysis to assess the efficacy and safety of CZP in the treatment of RA patients.
  
  
  METHODS
  Eligible studies were randomized controlled trials (RCTs) that evaluated the efficacy and safe of CZP in the patients with active RA. The primary outcome was American College of Rheumatology 20% (ACR20), and secondary outcome were ACR50, ACR70, disease activity, patient-reported outcomes (PROs), and adverse events. A fixed-effect model or random-effect model was used to pool the estimates, depending on the absence or presence of heterogeneity among the included studies.
  
  
  RESULTS
  Nine RCTs with a total of 5228 patients were included in this meta-analysis, and all of the patients were administered CZP or placebo. The pooled results showed that CZP significantly improved the ACR20, ACR50, ACR70 response rates, and physical function. CZP was associated with a statistically significant reduction in Disease Activity Score in 28 joints-Erythrocyte sedimentation rate, arthritis pain, and fatigue. Patients who received CZP treatment did not have a higher incidence of treatment-related adverse events, no matter in any intensity.
  
  
  CONCLUSIONS
  CZP 200 or 400mg in the treatment of active RA significantly reduced the RA signs and symptoms, and improved physical function as compared with the placebo. More large-scale RCTs are needed to evaluate the long-term efficacy and safety of CZP in the treatment of active RA.
authors.affiliation: Department of Orthopaedics, Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine Jiangsu 215021, China.
authors.forename: Qing
authors.initials: Q
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedics, Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine Jiangsu 215021, China.
authors.forename: Yaodong
authors.initials: Y
authors.lastname: Zhou
authors.affiliation: Department of Orthopaedics, Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine Jiangsu 215021, China.
authors.forename: Hao
authors.initials: H
authors.lastname: Chen
authors.affiliation: Department of Orthopaedics, Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine Jiangsu 215021, China.
authors.forename: Zhen
authors.initials: Z
authors.lastname: Wang
authors.affiliation: Department of Orthopaedics, Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine Jiangsu 215021, China.
authors.forename: Zhibing
authors.initials: Z
authors.lastname: Tang
authors.affiliation: Department of Orthopaedics, Suzhou Kowloon Hospital Affiliated to Shanghai Jiaotong University School of Medicine Jiangsu 215021, China.
authors.forename: Jinlian
authors.initials: J
authors.lastname: Liu
keywords: Certolizumab pegol; meta-analysis; rheumatoid arthritis