An anti-TNF biologic
Certolizumab pegol
An injectable anti-TNF biologic used for rheumatoid arthritis, psoriatic arthritis, ankylosing spondylitis and Crohn's disease.
What is Certolizumab pegol?
Certolizumab pegol is a biologic medicine that blocks the inflammatory messenger TNF, used for rheumatoid arthritis and other inflammatory arthritis, psoriasis and psoriatic arthritis, ankylosing spondylitis and Crohn's disease. It is given by injection under the skin and is not a tablet. Because it dampens the immune system, serious infection is the main risk, so you are screened for tuberculosis and hepatitis B and C before starting. Live vaccines must be avoided while on it, but routine jabs such as the flu vaccine are encouraged. It is one of the anti-TNF options sometimes considered when pregnancy is a factor, which your specialist will discuss with you.
Education and reference only. This is a plain-language guide to Certolizumab pegol — it deliberately contains no doses. Doses depend on the person, the brand and the reason for treatment, and belong with your prescriber. Always check the BNF, the product labelling (SmPC) and follow medical advice.
What it is
Certolizumab pegol is a biologic medicine, made using living cells rather than as a chemical tablet, and belongs to the anti-TNF group that calms an overactive immune system. It is used for rheumatoid arthritis and other forms of inflammatory arthritis, psoriasis and psoriatic arthritis, ankylosing spondylitis and Crohn's disease. It is given as an injection under the skin, which many people are taught to do at home. It is sold under the brand name Cimzia.
How it works
Certolizumab pegol attaches to and blocks tumour necrosis factor (TNF), a key messenger driving inflammation, which helps reduce joint swelling, pain, stiffness, skin inflammation and gut inflammation. By lowering TNF, it eases the damage caused by the overactive immune response. Because TNF also helps the body fight infection, blocking it weakens that defence, which is why infections such as tuberculosis can reactivate. The benefit builds over weeks and is reviewed to confirm the condition is responding.
Company & origin
Originated / developed by: UCB.
An anti-TNF biologic injection used in the UK for inflammatory arthritis, psoriasis and Crohn's disease.
What it treats
Conditions Certolizumab pegol is used for
Practical use
How to take Certolizumab pegol
General, dose-free guidance — always follow your prescriber's and the leaflet's specific instructions.
- It is given by injection under the skin as prescribed, not as a tablet.
- You or a carer can usually be taught to inject at home using a pre-filled syringe, rotating the site each time.
- Use it exactly as prescribed and keep going even when you feel well, as it controls a long-term condition.
- Store it in the fridge as instructed and let an injection reach room temperature before use to reduce stinging.
- Avoid live vaccines while on treatment and tell any healthcare professional that you take a biologic.
- Contact your team promptly if you develop a fever, persistent cough, night sweats or other signs of infection.
Weighing it up
Advantages & disadvantages of Certolizumab pegol
Advantages
- Effective at reducing pain, swelling and stiffness in inflammatory arthritis and at calming Crohn's disease.
- Given conveniently by injection under the skin and often self-administered at home.
- Often a preferred anti-TNF option to consider around pregnancy and breastfeeding, guided by a specialist.
Disadvantages
- Lowers the body's defences, so serious infections are more likely and need prompt attention.
- Requires tuberculosis and hepatitis screening before starting and ongoing monitoring.
- Cannot be given with live vaccines, and injection-site reactions can occur.
Practical use
Good to know
Certolizumab pegol quietens the immune system, so serious infection is the most important risk to understand. Before starting, you will be screened for tuberculosis and for hepatitis B and C, as these can reactivate during treatment. Live vaccines must be avoided while on it, but other vaccines such as the annual flu jab and pneumonia vaccine are encouraged and are best arranged before starting where possible. Report signs of infection, such as fever, persistent cough or night sweats, promptly. Like other anti-TNF medicines it is used with caution in heart failure and in people with a history of nerve conditions affecting the brain or spinal cord, and there is a small, carefully discussed possible signal of certain cancers such as lymphoma. Because of how it is made, it is one of the anti-TNF options a specialist may consider during pregnancy and breastfeeding, weighing the benefits and risks with you.
Who should not take it / use with caution
- People with an active serious infection, including active or untreated tuberculosis, should not start it until this is treated.
- It is generally avoided in moderate to severe heart failure and used very cautiously where there is a history of demyelinating nerve disease.
- It should not be used by people who have had a severe allergic reaction to certolizumab or its ingredients.
Monitoring
- Screening for tuberculosis and hepatitis B and C before starting, with ongoing watch for infection.
- Regular review of how well the condition is responding and whether to continue.
- Blood tests as advised, particularly if combined with other medicines such as methotrexate.
Side effects
- Injection-site reactions and an increased risk of infections such as colds, chest and urinary infections.
- Headache, rash and feeling generally unwell can occur.
- Less commonly, reactivation of tuberculosis or hepatitis B, and rare serious infections or allergic reactions needing urgent care.
Key interactions
- Should not be combined with live vaccines, which must be avoided during treatment.
- Combining it with another immune-suppressing biologic raises infection risk and is generally avoided.
- It is often used alongside methotrexate in arthritis, which your team will monitor together.
Available as: Pre-filled syringe for injection under the skin.
Answers
Certolizumab pegol: frequently asked questions
How is certolizumab given?
It is given by injection under the skin as prescribed, usually self-administered at home with a pre-filled syringe, and is not a tablet.
Why do I need screening before starting?
Because certolizumab dampens the immune system, you are screened for tuberculosis and hepatitis B and C beforehand, as these can reactivate during treatment.
Can I use it during pregnancy?
It is one of the anti-TNF medicines a specialist may consider around pregnancy and breastfeeding; this should always be discussed and decided with your team.
Can I have vaccinations on it?
Live vaccines must be avoided, but non-live vaccines such as the flu and pneumonia jabs are encouraged, ideally before you start.
What if I think I am getting an infection?
Contact your healthcare team promptly if you develop a fever, persistent cough, night sweats or other signs of infection, as these need checking.
The wider class
About Anti-TNF biologic
Certolizumab pegol belongs to the anti-tnf biologic class. For how the class as a whole works, its shared safety principles and monitoring, see the full guide.
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Authoritative sources
- BNF
- NICE CKS
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