Medications can be helpful in treating conditions on the AxSpA spectrum. There are various kinds of medications, including biologic DMARDs (disease-modifying antirheumatic drugs). One of these biologic DMARDs is certolizumab pegol, or the brand name drug Cimzia.
Certolizumab pegol was the first drug approved by the US Food and Drug Administration (FDA) for the treatment of non-radiographic axial spondyloarthritis (nr-AxSpA), in addition to radiographic axial spondyloarthritis (r-AxSpA), including ankylosing spondylitis (AS).1
What are the ingredients in certolizumab pegol?
In the prefilled syringe of Cimzia, the active ingredient is certolizumab pegol. Inactive ingredients include sodium acetate, sodium chloride, and water for injection.2 There are no preservatives.
How does certolizumab pegol work?
Certolizumab pegol is a tumor necrosis factor (TNF) blocker. This means the drug binds to a protein called a cytokine that is crucial in the inflammation process. The drug helps to block the substances that cause inflammation and suppress the immune reaction.3 Though the drug helps to suppress the immune reaction that causes inflammation, this means it can also suppress the immune system in general, so certain precautions should be taken when on this medication.
What are the possible side effects of certolizumab pegol?
Side effects can occur with any medication. Not everyone will have side effects, and those who do have side effects may not have the same side effects. If you start to have any adverse reactions or side effects, contact your doctor immediately.
The most common side effects of certolizumab pegol include upper respiratory infections like flu or cold, rash, headache, injection site reactions, and urinary tract infections.2,3
More serious side effects of this medication can include:2
- Heart failure (symptoms include shortness of breath, swelling of ankles, sudden weight gain)
- Allergic reactions
- Hepatitis B reactivation in those who are carriers
- Nervous system problems (new and/or worsening), including seizures, multiple sclerosis, inflammation of nerves in the eyes
- Blood problems like low white blood cell count or clotting problems
- Immune reactions (including a lupus-like syndrome) that include rash that gets worse in the sun, joint pain, shortness of breath
Certolizumab pegol may interact with other medications. Tell your doctor about all medications, supplements, vitamins, and over-the-counter drugs you might be taking, as well as any herbal or natural supplements.
Because certolizumab pegol suppresses the immune system, people taking this medication have reported serious infections like tuberculosis (TB). It’s important to tell your doctor about any illnesses or ailments you might have. Your doctor should monitor you closely while on this medication for signs and symptoms of infections, including TB. Talk with your doctor about your health history, and whether this medication is right for you.
Things to know about certolizumab pegol
If you are pregnant, plan to become pregnant, are breastfeeding, or plan to breastfeed, talk with your doctor. The Food and Drug Administration approved a label update in 2018 to Cimzia that includes pharmacokinetic data showing negligible to low transfer of the biologic through the placenta and minimal mother-to-infant transfer from breast milk. Therefore, some patients and physicians are choosing to use this medicine throughout pregnancy and breastfeeding and outcomes are being monitored closely.
If you are scheduled to get a vaccine, talk with your doctor. While taking this medication, you should not get any live vaccines.2
Dosing information
Cimzia can be prescribed as a powder, which a healthcare provider then needs to inject under your skin (subcutaneous injection), or as a prefilled syringe. If the prefilled syringe is prescribed, you or a family member will be trained in how to properly inject it. Certolizumab pegol is injected under the skin in either the abdomen or upper thighs.2,3