Certolizumab pegol in the treatment of Crohn's disease.

INTRODUCTION The introduction of antibodies directed against tumour necrosis factor (anti-TNF) has dramatically changed the concept of treating patients with Crohn's disease (CD). Unfortunately, the long-term efficacy of anti-TNF agents may be hampered by immunogenicity. The availability of more anti-TNF agents in the therapeutic armamentarium would therefore be of great benefit in patients loosing response to another anti-TNF. In this review, the authors will focus on the efficacy of certolizumab pegol (CZP). AREAS COVERED A literature search to January 2013 was performed to identify all trials studying CZP in patients with CD. The authors first focused on the mechanism of action of CZP. Second, they evaluated the efficacy of an induction and maintenance therapy with CZP and the impact of CZP on mucosal healing and fistula closure. Next, they explored the influence of previous anti-TNF exposure and baseline C-reactive protein levels. Finally, they analysed the safety data on CZP, including the development of antibodies against CZP and the use of CZP during pregnancy. EXPERT OPINION Based on the provided literature, CZP could be a good alternative in patients with moderate-to-severe CD failing another anti-TNF agent. More data are required to conclude on its impact on the long-term outcome of CD.