2019 Volume 31 Issue 4 Pages 314-320
Aim: To examine the clinical outcome of certolizumab pegol（CZP）in patients with rheumatoid arthritis（RA）.
Methods: Eighteen patients with RA（16 women and 2 men; mean age, 58.5±12.1 years; age range, 25-75 years; average disease duration, 6.3 years）who were given CZP were registered; of these 18 patients, 7 were biological agent–naïve. Twenty-one biological agents were previously used（etanercept, 8; adalimumab, 4; tocilizumab, 4; abatacept, 2; infliximab, 2; golimumab, 1）. Methotrexate was used in 14 cases（average dose, 7.1 mg/week; range, 4-10 mg/week）. Prednisolone was used in 5 cases（average dose, 4.5 mg/day; range, 2.5-5 mg/day）. The Disease Activity Score 28（DAS28）, European League Against Rheumatism response, retention rate, and adverse events were examined.
Results: The DAS28 score significantly decreased from 4.34（at first CZP administration）to 3.73（at 1.5 months after CZP administration）（p=0.0008）, to 3.10（at 3 months）（p=0.0037）, to 2.53（at 6 months）（p = 0.0006）, and 2.67（at 12 months）（p = 0.0019）. Moderate response was acquired in most cases（13/18, 72.2%）. The continuation rate was 67% at 24 weeks and 61% at 1 year. Administration was suspended for being ineffective in 5 cases（all of which were primary failures）and due to adverse events in 2 cases（1 for pain during injections and 1 because of worsening bronchial asthma, which was an underlying disease）.
Conclusions: Despite the high rate of refractory RA cases in this study, DAS28 showed low disease activity 6 months after CZP treatment, suggesting that CZP is effective for patients with refractory RA.
