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Plasma Drug Concentrations May Indicate Treatment Response

Plasma Drug Concentrations May Indicate Treatment Response

Tue, 03/10/2020 - 16:06

Findings from a recent study suggest that certolizumab pegol (Cimzia; CZP) concentrations are associated with improvements in disease activity among patients with rheumatoid arthritis (RA).

While the majority of patients achieve disease control while on anti-tumor necrosis factor inhibitors, up to 40% do not achieve disease control, the researchers said. “Drug concentration in plasma may be a factor affecting the observed variability in therapeutic response,” they added.

In the study, the researchers analyzed data from 3 randomized controlled clinical trials that included 1935 participants with RA treated with CZP. They assessed the association between plasma concentrations of CZP and improvement in disease activity, which were measured using the Disease Activity Score in 28 joints with C-reactive protein.
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The researchers found a possible exposure-response relationship between CZP concentration and low disease activity and remission at weeks 12 and 24, with the strongest association seen for low disease activity.

In addition, they also found CZP concentrations greater than or equal to 28.0 μg/mL at week 12 and greater than or equal to 17.6 μg/mL at week 24 were associated with a greater likelihood of achieving low disease activity and remission outcomes.

“Although confirmatory studies are warranted to define the optimal CZP therapeutic range at Weeks 12 and 24, these data indicate that CZP concentrations may be associated with improvement of disease activity,” the researchers concluded.


Paul S, Marotte H, Kavanaugh A, et al. Exposure-response relationship of certolizumab pegol and achievement of low disease activity and remission in patients with rheumatoid arthritis [published online February 26, 2020]. Clin Transl Sci. doi:10.1111/cts.12760

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