Real-World Methotrexate Dose on Clinical Effectiveness and Structural Damage of Certolizumab Pegol With Rheumatoid Arthritis

• Published in: Frontiers in medicine 2021-04, Vol.8, p.643459-643459
• Main Authors: Nozaki, Yuji, Hidaka, Toshihiko, Ri, Jinhai, Itami, Tetsu, Tomita, Daisuke, Okada, Akinori, Ashida, Chisato, Ikeda, Fusayo, Yamamoto, Atsuhiro, Funahashi, Keiko, Kinoshita, Koji, Matsubara, Tsukasa, Funauchi, Masanori, Matsumura, Itaru
• Format: Article
• Language: English
• Subjects: biological; certolizumab pegol; cytokines; DAS28-ESR; Medicine; rheumatoid arthritis; X ray
• ISSN: 2296-858X; 2296-858X
• DOI: 10.3389/fmed.2021.643459

Rheumatoid arthritis (RA) treatments have markedly advanced with the introduction of biological agents, e. g., tumor necrosis factor (TNF) inhibitors. TNF inhibitors are demonstrated to be quite effective in combination with methotrexate (MTX), and sufficient doses of both agents are important to control RA's disease activity. However, not all RA patients can be treated with high-dose MTX due to contraindications related to the antimetabolite action of MTX or to tolerability concerns. In daily practice, this has resulted in reduced effectiveness of TNF inhibitors. We sought to determine whether the concomitant use of dose of MTX affected the clinical effectiveness, retention rate, and side effects of certolizumab pegol (CZP) for treating RA in a real-world setting. CZP is a pegylated-conjugated Fab' fragment of a humanized anti-TNF antibody that has high affinity to TNF. We divided Japanese RA patients treated with CZP ( = 95, 25-83 years old) into groups based on those with ( = 65) and without ( = 30) concomitant MTX and those treated with a high dose (≥8 mg, = 41) or low dose (1-