EDITORIAL
Editorials
New tumour necrosis factor inhibitors for rheumatoid arthritis: are there benefits from extending choice?
1 Academic Department of Rheumatology, King’s College London School of Medicine, Weston Education Centre, King’s College London, London, UK
2 Academic Department of Rheumatology, King’s College London School of Medicine, Guy’s Hospital, London, UK
Correspondence to:
Professor D L Scott, Academic Department of Rheumatology, King’s College London School of Medicine, Weston Education Centre, King’s College London, 10 Cutcombe Road, London SE5 9RS, UK; david.l.scott@kcl.ac.uk
Accepted 10 March 2009
| The first 150 words of the full text of this article appear below. |
Certolizumab pegol (UCB, Brussels, Belgium) and golimumab (Centocor, Horsham, Pennsylvania, USA) are the latest tumour necrosis factor (TNF) inhibitors evaluated in double-blind, multicentre randomised controlled trials (RCT). Certolizimab is the pegylated (polyethylene glycolated) Fab' fragment derived from a high affinity humanised anti-TNF
monocolonal antibody (mAb). Fab' fragments lack the Fc portion of immunoglobulin, and so the repertoire of Fc-mediated effector responses, such as complement or antibody-dependent cell-mediated cytotoxicity, is distinct from those of other anti-TNF mAb. Nonetheless, it still neutralises membrane TNF. Derivatisation of the Fab' fragment prolongs the plasma half-life to 2 weeks. Certolizumab pegol is administered by subcutaneous injection (200 or 400 mg) every 2 weeks. Golimumab is a human anti-TNF mAb administered by subcutaneous injections (50 or 100 mg) every 4 weeks. Three RCT in this issue of Annals of the Rheumatic Diseases,1–3 (see pages 789, 797 and 805) which report their
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