The Medical Letter on Drugs and Therapeutics
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Certolizumab (Cimzia) for Crohn's Disease

The FDA has approved the marketing of certolizumab pegol (Cimzia – UCB), a tumor necrosis factor (TNF) blocker, for treatment of moderate to severe Crohn’s disease refractory to conventional treatment. It is the third TNF blocker approved for this indication.

MECHANISM OF ACTION — Tumor necrosis factor alpha (TNFa) is a pro-inflammatory cytokine. Certolizumab is a PEGylated Fab fragment of a humanized anti-TNFa antibody. Antibodies and antibody fragments that bind TNFa block the inflammatory cascade.1 Unlike infliximab and adalimumab, certolizumab does not induce complement-activated cytotoxicity, antibodydependent T-cell mediated cytotoxicity, or apoptosis. The effect of these mechanistic differences on drug efficacy and tolerability has not been established.

CLINICAL STUDIES — In a dose-response study, 292 patients with moderate to severe Crohn's ... more      

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