| Common Brands | Cimzia |
|---|---|
|
Drug Class |
Tumor Necrosis Factor (TNF) Inhibitors |
|
Controlled Substance Classification |
Not a controlled medication |
|
Generic Status |
Lower-cost generic available |
|
Availability |
Prescription only |
A biologic medication that has brand names Cimzia, this drug is employed for the treatment of various forms of autoimmune diseases. An anti-TNF-alpha monoclonal antibody, it serves by blocking a protein called tumour necrosis factor (TNF-alpha). It is also involved in a range of inflammation, including those conditions like RA, Crohn’s disease and psoriasis where there is over-expression of the said protein. This medication simply helps to manage symptoms of inflammatory chronic disorders with reduced inflammation.
Certolizumab is developed by UCB Pharma and is administered through subcutaneous injection. It is used when other treatments have failed or in patients with moderate to severe disease activity.
Subcutaneous injection is the mode of administration for certolizumab. Injection is typically given by a health care professional in a clinical setting, but many patients can eventually learn to give themselves injections in the home with proper training.
Important points regarding proper administration
Certolizumab is available in prefilled syringes or auto-injectors. These are designed for the convenience and simplicity of use of the patient.
It is injected into the fatty tissue under the skin, typically in the abdomen or thigh.
The injection should be given at room temperature, so it is important to allow the medication to warm up before administration. It should not be heated or microwaved.
If the injection site becomes red, swollen, or painful, the patient should rotate the injection sites to reduce irritation.
Patients are required to take the dose in the prescription exactly as prescribed in order to attain full benefits.
The drug certolizumab acts through binding to and neutralizing TNF-alpha, a cytokine implicated in systemic inflammation. TNF-alpha is important for the inflammatory processes that cause pathogenesis in most autoimmune diseases. It triggers the immune system, causing inflammation that leads to tissue damage and progression of the disease.
By neutralizing TNF-alpha, certolizumab:
It reduces the inflammatory response in rheumatoid arthritis and Crohn’s disease.
It reduces the synthesis of other pro-inflammatory cytokines and adhesion molecules that facilitate the movement of immune cells.
It also helps prevent further damage to the joints, gastrointestinal tract, and skin.
This mechanism helps in managing the activity of the disease, reducing symptoms like pain and swelling, and enhancing the quality of life of people suffering from autoimmune diseases.
Side effects may occur with certolizumab, though not everyone experiences them. Some common side effects include:
Injection site reactions: Redness, swelling, itching, or pain at the injection site.
Upper respiratory infections: Cough, sore throat, and sinus congestion.
Headache: Some patients may experience headaches while using
Gastrointestinal issues: Nausea, diarrhea, and abdominal pain.
Fatigue: Some individuals may feel unusually tired or fatigued.
Serious but less common side effects include:
Infections: Certolizumab may increase the risk of serious infections, such as tuberculosis or opportunistic infections.
Liver problems: Liver enzyme elevations or hepatitis may occur in some patients.
Heart problems: Rarely, certolizumab can affect the heart, leading to heart failure or other issues.
Cancer risk: Long-term use of TNF inhibitors like certolizumab has been associated with an increased risk of certain cancers, such as lymphoma.
In the case of the patient with a history of any kind of infection (fever, chills, muscle pain), liver-related issue (jaundice -yellowing of skin or yellow eyes), allergic reactions, these symptoms should lead patients to hospital emergencies immediately.
Prior to and during administration of Certolizumab, a few warnings and precautions need consideration.
Infections: Patients should be tested for tuberculosis (TB) before starting certolizumab, and treatment for latent TB should be completed if necessary. The drug should be discontinued if a serious infection occurs.
Heart failure: Certolizumab may worsen heart failure or increase the risk of new heart failure. It should be used with caution in patients with a history of heart disease.
Immunosuppression: Since certolizumab suppresses the immune system, it may increase the risk of infections and reduce the body’s ability to fight infections.
Cancer: There is a potential increased risk of certain cancers, such as lymphoma, especially with long-term use of TNF inhibitors.
Liver function: Liver enzyme levels should be monitored, as certolizumab can cause liver damage in some cases.
Patients should report any history of infections, cancer, heart disease, or liver problems to their doctor before initiating therapy with certolizumab.
Certolizumab pegol (Cimzia) is given by subcutaneous injection. The dosing schedule can only be determined according to what disease is being treated and patient’s response to therapy.
Rheumatoid Arthritis (RA): It is started at a dose of 400 mg, every two weeks for the first three doses, and then 200 mg every two weeks or 400 mg every four weeks as recommended by a physician.
Crohn’s Disease: The usual initiating dosage is 400 mg at weeks 0, 2 and 4, followed by 400 mg every four weeks.
Ankylosing Spondylitis and Psoriatic Arthritis: This follows an identical dosage regimen to that of RA.
The interaction of certolizumab with other immunosuppressive drugs or biologic therapies is possible. Care should be taken when combining certolizumab with other TNF inhibitors or drugs that suppress the immune system, as this may increase the risk of infections or other side effects.
The administration of certolizumab differs according to the condition treated:
Rheumatoid arthritis: Usually, 400 mg administered subcutaneously at weeks 0, 2, and 4, then 200 mg every two weeks or 400 mg every four weeks.
Crohn’s disease: 400 mg at weeks 0, 2, and 4, then 400 mg every four weeks.
Psoriatic arthritis: The same as in the treatment of rheumatoid arthritis.
Ankylosing spondylitis: 400 mg at weeks 0, 2, and 4, then every 4 weeks.
The patient must be on the required dose and interval as determined by the doctor and may need dose adjustment based on the patient’s response to treatment.
Certolizumab is a prescription medication. It should only be prescribed by a healthcare provider who has expertise in the treatment of autoimmune conditions. The healthcare provider will first review the patient’s medical history, check for infections such as tuberculosis, and ensure that the medication is suitable for the patient’s condition before prescribing certolizumab.
Patients are expected to report to their healthcare provider regularly for follow-up assessments on side effects and effectiveness of the treatment.
Answer: Certolizumab is a biologic medication used to treat various autoimmune disorders by blocking tumor necrosis factor (TNF), a substance that causes inflammation in the body.
Answer: The brand name of Certolizumab is Cimzia.
Answer: Certolizumab is used to treat rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis, Crohn’s disease, and non-radiographic axial spondyloarthritis.
Answer: It works by blocking TNF-alpha, a pro-inflammatory cytokine, which helps reduce inflammation and slow disease progression.
Answer: No, Certolizumab is a biologic TNF inhibitor, not a steroid.
Answer: Certolizumab is given as a subcutaneous injection, either by a healthcare provider or self-administered at home after proper training.
Answer: The dosing schedule may vary, but it’s often every 2 to 4 weeks following an initial loading dose.
Answer: Yes, patients can learn to self-inject using a prefilled syringe or pen after receiving proper instruction.
Answer: Common side effects include injection site reactions, upper respiratory infections, rash, and urinary tract infections.
Answer: Serious risks may include serious infections, tuberculosis, heart failure, liver problems, and certain cancers.
Answer: Yes, as a TNF inhibitor, it suppresses the immune response, increasing the risk of infections.
Answer: Yes, a TB test is required before starting Certolizumab, and regular monitoring is recommended during treatment.
Answer: Certolizumab is sometimes considered safer than other biologics during pregnancy due to its minimal placental transfer in the third trimester.
Answer: Yes, studies suggest limited transfer into breast milk, and it is considered compatible with breastfeeding by some guidelines.
Answer: No, Certolizumab is currently available only under the brand name Cimzia.
Answer: Some patients may experience improvement in symptoms within a few weeks, but full effects may take longer.
Answer: Yes, many patients use Certolizumab long-term to manage chronic inflammatory conditions, under medical supervision.
Answer: Certolizumab (Cimzia) is manufactured by UCB, Inc.
Answer: Take the missed dose as soon as you remember, but do not double up—consult your doctor on how to adjust your schedule.
Answer: Yes, other biologic TNF inhibitors include adalimumab (Humira), etanercept (Enbrel), and infliximab (Remicade), but suitability varies by patient.
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