Comparable Safety Outcomes With Certolizumab Pegol, Other TNFis in RA

Cellulitis of the wrist
Cellulitis of the wrist
Investigators examined the incidence of serious infectious events during the use of certolizumab pegol vs other TNFi for RA in the United States.

Certolizumab pegol (CZP), a tumor necrosis factor inhibitor (TNFi) approved for the treatment of adult patients with moderate-to-severe active rheumatoid arthritis (RA), demonstrated similar safety outcomes compared with other TNFis, according to a prospective, observational cohort study published in Arthritis Research & Therapy.

Because of a lack of data on the safety of CZP compared with other TNFis in the United States, researchers used the Consortium of Rheumatology Researchers of North America (Corrona) registry to identify and follow adult patients with RA initiating CZP or other TNFis (etanercept, adalimumab, golimumab, or infliximab) after May 1, 2009 (n=6215 initiations).

They found that patients were more likely to initiate CZP later in the course of therapy than other TNFis, and that CZP initiators (n=975) were older, had longer disease duration, had more active disease, and had greater disability than those starting other TNFi therapies (n=5240). Propensity score (PS) matching was used to control for baseline characteristics associated with the probability of receiving CZP vs other TNFis and demonstrated no clinically important differences between CZP (n=952) and other TNFis (n=952) after PS matching.

CZP was associated with a greater incidence of serious infectious events before PS matching, but after PS matching, the risk for serious infectious events was not different between the groups. Regardless of PS matching, there was no difference in risk between CZP and other TNFis for malignancies or cardiovascular events.  

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The authors concluded that, “In a PS-matched cohort of patients with moderate to severe RA enrolled in the Corrona registry, there were no differences in the 1-year risk of [serious infectious events], malignancies, and [cardiovascular events] between patients treated with CZP and those treated with other TNFi.”


Harrold LR, Litman HJ, Saunders KC, et al. One-year risk of serious infection in patients treated with certolizumab pegol as compared with other TNF inhibitors in a real-world setting: data from a national U.S. rheumatoid arthritis registry. Arthritis Res Ther. 2018;20(1):2.