Profile of certolizumab and its potential in the treatment of psoriatic arthritis

Figures & data

Figure 1 Enthesal and Joint pathology in Psoriatic Arthritis. The origin of Inflammation in the enthesal complex in PsA is multifactorial. When stimulated by stress, infections and trauma (Koebner phenomenon), in a genetic background, fibroblast-like synoviocytes express selfDNA or/ and secrete inflammatory cytokines and MMPs. They produce complement system factors as C3 and C4 and express less CD59 during inflammation, who is an inhibitor of complement system activation. The activation of the complement system lead to the release of C5a and production of MAC with the lysis of cells and recruitment of immune cells. FLS secrete MCP-1 and IL-8 necessary for recruitment and activation of MΦ. Polyclonal activation of CD4+Tcells and Th17 is the consequence of the immunological synapse with DC linked to the binding with CD80/86 and CD28. When activate CD4+ Tcells produce: RANKL with activation of OC with the consequence of bone erosions and VEGF with the activation of endothelial cells and the formation of HEV

Abbreviations: PsA (Psoriatic Arthritis); FLS (fibroblast-like synoviocytes); TNF (Tumor Necrosis Factor); MMP (Matrix metalloproteinases); MCP-1 (monocyte chemotactic protein-1); OC (Osteoclast); MΦ, (monocytes/macrophages); RANK/RANKL (Receptor activator of nuclear factor kappa-B/ ligand); MAC (membrane attack complex); VEGF (vascular endothelial growth factor); Th17 (T helper 17); DC (dendritic cell); CD (cluster differentiation).

Table 1 Clinical indications of certolizumab pegol

	Present indications	Futures indications
Europe (EMA)	RA	CD, PsO, PsA and SpA
Swiss	RA, CD	PsO, PsA and SpA
Russia	RA, CD	PsO, PsA and SpA
USA	RA, CD	PsO, PsA and SpA
Canada	RA, CD
Chile, Mexico	RA, CD	PsO, PsA and SpA
Argentina	RA, CD
Australia	RA	CD, PsO, PsA and SpA
Asia	RA	CD, PsO, PsA and SpA
Japan	RA

Notes: Cetolizumab pegol was approved for the treatment of rheumatoid arthritis in the EU, US and Canada in 2009, and for the treatment of Crohn’s Disease in Switzerland in 2007 and in the USA in 2008. Certolizumab pegol is entering into an increasingly competitive marketplace, especially in rheumatoid arthritis, but clinical data demonstrate benefits across a range of other inflammatory disease.

Abbreviations: EMA, European Medicines Agency; RA, Rheumatoid Arthritis); CD, Crohn’s disease; PsO, Psoriasis; PsA, Psoriatic Arthritis; SpA Spondyloarthritis.