Certolizumab pegol for the treatment of psoriatic arthritis

Certolizumab pegol (CZP) is a TNF-alpha inhibitor approved for the treatment of psoriatic arthritis in 38 countries, including many European countries and the USA. It is a pegylated humanized anti-TNF-alpha antigen-binding fragment, administered subcutaneously. As other TNF-alpha antibodies, CZP binds to and neutralizes both soluble and membrane TNF-alpha. In contrast to whole antibodies and etanercept, CZP does not activate antibody-dependent cell-mediated cytotoxicity or complement-dependent cytotoxicity, as it does not have an Fc piece. CZP showed efficacy in improving skin scores and patient reported outcomes in a Phase II study of 176 adults with moderate-to-severe plaque psoriasis. In a Phase III study of CZP in 409 psoriatic arthritis patients, CZP treatment resulted in improvements in peripheral arthritis, as well as dactylitis, enthesitis, nail disease and quality of life. The safety profile of CZP appears to be similar to that of other TNF-alpha inhibitor.