Certolizumab Pegol Effective in Rheumatoid Arthritis Patients with high RA factor: Study

A recent post hoc analysis of the EXXELERATE study revealed that certolizumab pegol (CZP) sustained drug concentration and efficacy in rheumatoid arthritis (RA) patients with varying baseline rheumatoid factor (RF) levels compared to adalimumab (ADA). The findings were published in the Rheumatology journal.

Rheumatoid arthritis is a chronic autoimmune condition that often features elevated levels of RF, an antibody that targets the body’s own tissues and can exacerbate disease severity. RF levels are frequently used to gauge the aggressiveness of RA and predict treatment outcomes. In this study, baseline RF levels were divided into quartiles, with patients grouped into either ≤204 IU/ml (≤Q3) or >204 IU/ml (>Q3) RF categories. A total of 907 patients were included in the analysis, split almost evenly between those treated with CZP and ADA.

The finding suggest that, while CZP maintained stable drug concentration levels regardless of the RF baseline, ADA demonstrated a decrease in drug concentration for patients with RF levels above 204 IU/ml. The area under the curve (AUC), which measured overall drug exposure over time was lower in ADA-treated patients with high RF when compared to the ones with lower RF levels. This contrast highlights a potentially significant difference in drug pharmacokinetics between the two TNF inhibitors, especially in patients with high RF levels, which may impact drug efficacy.