Certolizumab (Cimzia)
Cimzia (certolizumab) is a biologic medicine that helps the pain and swelling of arthritis. It works by blocking Tumor Necrosis Factor (TNF), a type of signalling protein (called a cytokine), that is involved in systemic inflammation.
Cimzia belongs to a class of similar medications called “Anti-Tumor Necrosis Factor” agents.
Cimzia is used to treat Rheumatoid Arthritis, Psoriatic Arthritis, Ankylosing Spondylitis, Psoriasis, and Crohn’s Disease.
Taking Cimzia
Cimzia is available in pre-filled syringes or an autoinjectors and is usually taken once every 2 weeks.
The normal dose is 400 mg every 2 weeks for the first 3 doses, then 200 mg every 2 weeks after that.
Watch our video to learn how inject Cimzia at home:
Learn how to inject subcutaneous injectionsLearn how to inject autoinjectorsSubcutaneous injections (under the skin injections) are easy to do compared to other types of injections. A small needle pokes just under the skin to deliver medicine into the “fatty tissue” below.
Although some patients can feel better quite quickly in others it can take a little longer. Patients starting Cimizia should continue taking the medication as prescribed.
The manufacturer of Cimzia offers a support program to Canadian patients that are prescribed the medication:
Patient support program enrolment formsImportant Tests and Risks
Cimzia can make it a bit harder for people to fight off infections.
People that take this medicine should call their doctor if they have a fever, think they have an infection, or have been prescribed antibiotics to treat an infection.
Treatment should be stopped before any surgery. It can be re-started once things have healed and there’s no sign of infection. Most patients stop the medication two to four weeks before surgery. It can be restarted 10-14 days after the surgery as long as there is no sign of infection.
Patients should discuss all vaccinations with their doctor because some (live vaccines) are not advisable to get while taking Cimzia.
It is important to get a TB (tuberculosis) skin test and a chest x-ray before starting Cimzia.
Science
In some people with arthritis, a signalling protein (cytokine) called Tumor Necrosis Factor (TNF) is present in the blood and joints in excessive amounts where it increases inflammation (pain and swelling).
Cimzia is another type of protein called a monoclonal antibody that works as a Tumor Necrosis Factor blocker. It binds to Tumor Necrosis Factor and prevents it from working. Normally Tumor Necrosis Factor would bind to Tumor Necrosis Factor receptors in the body and cause inflammation.
In blocking Tumor Necrosis Factor, Cimzia suppresses the body’s immune system. Though this suppression can make it slightly harder for patients to fight off infections, it also helps to stabilize an overactive immune system and control arthritis.
Safety
MORE COMMON side-effects include:
- Mild skin reaction at the injection site (itchiness, redness, and mild swelling).
- Nausea, abdominal pain
- Headache
- Rash
- Upper respiratory tract infections (such as sinusitis).
RARE side-effects include:
- Infection – There is an increased risk of serious infections associated with the use of Cimzia. Any infections or fevers should be taken very seriously and reviewed by a doctor.
- Nervous System – There have been rare reports of some patients developing disorders that affect the nervous system (multiple sclerosis, seizures, or inflammation of the nerves of the eye) while taking medications like Cimzia. Fortunately, these reports are exceedingly rare.
- Heart – Patients should inform their doctor if they have congestive heart failure as Cimzia may make it worse.
- Blood Counts – Cimzia can cause a drop in the numbers of white blood cells (which are needed to fight infection) or red blood cells (which carry oxygen). This is very rare and it is unusual for this to be a serious problem.
- Malignancy – When used for long periods of time, Cimzia may be associated with a small increased risk of cancer, however, the data is not entirely clear.
How to minimize the side-effects of Cimzia:
- Take Cimzia as prescribed by a doctor
Who Should NOT Take Cimzia
Patients who should NOT be taking Cimzia (certolizumab) include:
- Patients who have had a previous serious allergic reaction to Cimzia
- Possibly patients who have cancer or have had a past history of certain cancers
- Patients who have severe or uncontrolled congestive heart failure
- Patients who have multiple sclerosis
- Patients with active infections (such as tuberculosis)
Cimzia is felt to be safe in pregnancy. However, anyone who becomes pregnant while taking Cimzia should let their doctor know.
Pregnancy and medicationsPeople taking Cimzia should call their doctor if they feel sick and want to stop, or if they are concerned about any side effects.
Other reasons to call a doctor while taking Cimzia include:
- Fever or possible infection
- If another doctor has prescribed antibiotics to fight an infection
- Before having surgery
- Planning to get any vaccinations
- Rash
Video
Watch Dr. Andy Thompson, a Canadian rheumatologist, introduce Cimzia in a short video:
Resources
DIN
- 02331675 (Pre-filled Syringe)
- 02465574 (Autoinjector)