Division of Musculoskeletal Disease, Leeds Institute of Molecular Medicine, University of Leeds, 2nd Floor, Chapel Allerton Hospital, Chapeltown Road, Leeds, LS7 4SA, UK.
Expert Opin Biol Ther. 2012 Feb;12(2):235-49. doi: 10.1517/14712598.2012.645533. Epub 2011 Dec 14.
Improved understanding of the pathogenesis of rheumatoid arthritis (RA), and subsequent development of targeted therapies, have greatly advanced the management of this chronic inflammatory disease. The aim of treatment is a state of clinical remission. Certolizumab pegol (CZP) is a novel pegylated TNF alpha inhibitor (TNFi) therapy and is the focus of this review.
CZP is different from other TNFi as it contains a polyethylene glycol (PEG) moiety, and lacks the constant fragment (Fc) of immunoglobulin; therefore it does not activate complement. In this review in addition to clinical efficacy of CZP, effects on radiographic and patient-reported outcomes, are discussed. Adverse event data from clinical trials and extension studies are also reviewed.
The addition of novel TNFi therapies to treat RA is welcomed. As well as displaying clinical efficacy, there is evidence to suggest that CZP has unique characteristics, including reduced transfer across the placenta and reduced frequency of injection site reactions. Furthermore, randomised controlled trials (RCTs) of CZP have demonstrated rapid improvements in workplace and home productivity in patients contributing to reducing the significant socioeconomic burden of RA.
类风湿关节炎（RA）发病机制的认识不断提高，随后靶向治疗的发展极大地推动了这种慢性炎症性疾病的治疗。治疗的目的是达到临床缓解。培塞利珠单抗（CZP）是一种新型聚乙二醇化 TNF-α抑制剂（TNFi），是本次综述的重点。
与其他 TNFi 不同，CZP 含有聚乙二醇（PEG）部分，缺乏免疫球蛋白的恒定片段（Fc），因此不会激活补体。在本次综述中，除了讨论 CZP 的临床疗效外，还讨论了对影像学和患者报告结局的影响。还回顾了临床试验和扩展研究的不良事件数据。
新型 TNFi 治疗药物的加入受到欢迎。除了显示出临床疗效外，有证据表明 CZP 具有独特的特性，包括降低胎盘转移和减少注射部位反应的频率。此外，CZP 的随机对照试验（RCT）显示，患者的工作场所和家庭生产力迅速提高，有助于减轻 RA 带来的巨大社会经济负担。
