Medically reviewed by Matthew Hamilton, MD
Often referred to by its brand name, Cimzia, certolizumab pegol is a biologic medication used to treat moderate to severe Crohn’s disease (CD). It belongs to a group of drugs called anti-TNF agents, which help prevent a protein called tumor necrosis factor (TNF) from inflaming the intestines.
“By tuning down or stopping the inflammation, those areas heal, and when those areas heal, patients typically have less symptoms,” says Kim Isaacs, MD, PhD, co-director of the UNC Multidisciplinary Center for IBD Research and Treatment in Chapel Hill, North Carolina. It’s in this way that Cimzia helps achieve and maintain CD remission.
Like other medications meant for inflammatory bowel disease (IBD), Cimzia comes with benefits, risks—and a host of misconceptions. Here’s the lowdown on how it really works.
Myth 1: To address CD symptoms, always take a biologic like Cimzia first.
Most frequently, Cimzia is prescribed when other drugs aren’t working well enough. For example, if corticosteroids can’t bring a flare under control, a provider may use Cimzia to get the job done.
Biologics aren’t typically given up front due to the high price and safety profile. However, early use may be appropriate in some cases, especially if signs point to an aggressive disease course. “The key thing,” says Dr. Isaacs, “is to have a discussion with a physician and make sure the disease is at a point where it’s reasonable to be on one of these more potent agents.”
Myth 2: You’ll feel better soon after your first dose.
Though many CD patients start improving within a few weeks, some can take Cimzia for about two months before symptoms subside—and others might not respond, period. To boost its efficacy, doctors may pair the medication with an immunomodulator drug, such as methotrexate or azathioprine. This is called combination therapy.
Myth 3: Cimzia has to be administered by a doctor.
Cimzia comes in injection form; you can self-inject or receive the shots from a healthcare provider. If you decide to inject yourself, a provider can show you the correct way. In some situations, says Isaacs, CD patients may have to receive treatment at a medical facility for insurance reasons.
The first three shots of Cimzia are spaced two weeks apart. After that, you’ll typically have one injection every four weeks.
Myth 4: Everyone with moderate to severe CD can take Cimzia.
People with certain health conditions may need alternate treatments, including those with:
- Serious infections
- Cancer or a history of cancer
- Congestive heart failure
- Neurological conditions, including multiple sclerosis
Hepatitis B and tuberculosis can be reactivated by Cimzia if you’ve been exposed to them in the past; Crohn’s patients should be screened for both prior to beginning injections.
Women who are pregnant, nursing or trying to conceive should inform their IBD team. Speak up about vaccinations, too; immunizations ought to be current before starting a biologic.
Myth 5: The risks of taking biologics like Cimzia are greater than the benefits.
For many patients, untreated or inadequately treated CD is more dangerous than the potential for complications and side effects.
Still, Cimzia’s side effects should be taken into account when deciding whether to use the drug. The most common are joint pain, weight gain, swelling and rash, along with upper respiratory and urinary tract infections. More serious issues include heart problems, nervous system difficulties, immune system troubles and allergic reactions.
Taking Cimzia may also increase your odds of serious infection or skin cancer. There is a slight risk of developing lymphoma, a cancer of certain white blood cells, as well. “It’s a very, very, very small risk, but we do worry about that with the anti-TNF agents,” says Isaacs.
Myth 6: Once you’re on Cimzia, you’re on it for good.
Though many CD patients use the medication successfully for years, others develop a resistance over time, requiring a change in therapy. “It really is very, very individualized,” says Isaacs.
That said, if Cimzia continues working, you likely won’t switch. “Once patients start with something in the anti-TNF class,” she explains, “we tend to stay with that drug until they lose efficacy or if they have side effects from the drug.”
Myth 7: You can stop Cimzia injections when symptoms go away.
The absence of noticeable symptoms doesn’t mean CD is cured. Crohn’s is a chronic condition, and managing it is a continuing process. Ending treatment on your own may endanger your health.
“Once we get it in control, we want to keep it in control,” says Isaacs, “and for many people, that means being on long-term medication.”
Medical reviewer and Oshi physician-partner Matthew J. Hamilton, MD is an Assistant Professor of Medicine at Harvard Medical School and a specialist in Gastroenterology, Hepatology, and Endoscopy at Brigham and Women’s Hospital Crohn’s and Colitis Center in Boston. He is a leading member of the research team at the BWH Crohn’s and Colitis Center, and has garnered national recognition for his research into the underlying inflammatory processes of IBD.
Oshi is a tracking tool and content resource. It does not render medical advice or services, and it is not intended to diagnose, treat, cure, or prevent any disease. You should always review this information with your healthcare professionals.