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. 2014 Nov 15;7(11):3870-80.
eCollection 2014.

The efficacy and safety of certolizumab pegol (CZP) in the treatment of active rheumatoid arthritis (RA): a meta-analysis from nine randomized controlled trials

Qing Zhou  1 , Yaodong Zhou  1 , Hao Chen  1 , Zhen Wang  1 , Zhibing Tang  1 , Jinlian Liu  1
Affiliations

The efficacy and safety of certolizumab pegol (CZP) in the treatment of active rheumatoid arthritis (RA): a meta-analysis from nine randomized controlled trials

Qing Zhou et al. Int J Clin Exp Med. .

Abstract

Objective: Certolizumab pegol (CZP) is a novel anti-TNF agent that is used for patients with moderate to severe active rheumatoid arthritis (RA). However, the efficacy of CZP in RA remains controversial. Thus, we performed this meta-analysis to assess the efficacy and safety of CZP in the treatment of RA patients.

Methods: Eligible studies were randomized controlled trials (RCTs) that evaluated the efficacy and safe of CZP in the patients with active RA. The primary outcome was American College of Rheumatology 20% (ACR20), and secondary outcome were ACR50, ACR70, disease activity, patient-reported outcomes (PROs), and adverse events. A fixed-effect model or random-effect model was used to pool the estimates, depending on the absence or presence of heterogeneity among the included studies.

Results: Nine RCTs with a total of 5228 patients were included in this meta-analysis, and all of the patients were administered CZP or placebo. The pooled results showed that CZP significantly improved the ACR20, ACR50, ACR70 response rates, and physical function. CZP was associated with a statistically significant reduction in Disease Activity Score in 28 joints-Erythrocyte sedimentation rate, arthritis pain, and fatigue. Patients who received CZP treatment did not have a higher incidence of treatment-related adverse events, no matter in any intensity.

Conclusions: CZP 200 or 400mg in the treatment of active RA significantly reduced the RA signs and symptoms, and improved physical function as compared with the placebo. More large-scale RCTs are needed to evaluate the long-term efficacy and safety of CZP in the treatment of active RA.

Keywords: Certolizumab pegol; meta-analysis; rheumatoid arthritis.

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Figures

Figure 1
Figure 1
Identification of eligible randomized-controlled trials.
Figure 2
Figure 2
Comparison of certolizumab pegol (CZP) with placebo for active ankylosing spondylitis (AS) patients in terms of ACR20 response rate.
Figure 3
Figure 3
Subgroup analysis of ACR20 response rate for the treatment of certolizumab pegol (CZP) versus placebo.
Figure 4
Figure 4
Comparison of certolizumab pegol (CZP) with placebo for active ankylosing spondylitis (AS) patients in terms of ACR50 response rate.
Figure 5
Figure 5
Subgroup analysis of ACR50 response rate for the treatment of certolizumab pegol (CZP) versus placebo.
Figure 6
Figure 6
Comparison of certolizumab pegol (CZP) with placebo for active ankylosing spondylitis (AS) patients in terms of ACR70 response rate.
Figure 7
Figure 7
Subgroup analysis of ACR70 response rate for the treatment of certolizumab pegol (CZP) versus placebo.
Figure 8
Figure 8
Disease Activity Score 28-joint assessment erythrocyte sedimentation rate (DAS28-ESR) for the treatment of certolizumab pegol (CZP) versus placebo.
Figure 9
Figure 9
Patients-reported outcomes (PROs) for the treatment of certolizumab pegol (CZP) versus placebo.
Figure 10
Figure 10
The risk ratio of treatment-related adverse events (AEs) in AS patients with certolizumab pegol (CZP) versus placebo.
See this image and copyright information in PMC

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