Certolizumab pegol plus methotrexate is not superior to adalimumab plus methotrexate for patients with active rheumatoid arthritis despite methotrexate therapy, according to the 2-year results of the EXXELERATE study, a randomised, head-to-head superiority trial (n = 915). The proportions of patients classified as responders at week 12 and at week 104 were similar in both treatment groups. The study also determined that switching to a second TNF inhibitor without a washout period is safe and effective for some patients classified as non-responders at week 12; 40 (62%) of 65 patients who switched from certolizumab pegol to adalimumab, and 33 (58%) of 57 patients who switched from adalimumab to certolizumab pegol, achieved a reduction in DAS28-ESR ≥1.2 or low disease activity 12 weeks after switching treatment.
References
Smolen, J. S. et al. Head-to-head comparison of certolizumab pegol versus adalimumab in rheumatoid arthritis: 2-year efficacy and safety results from the randomised EXXELERATE study. Lancet http://dx.doi.org/10.1016/S0140-6736(16)31651-8 (2016)
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Onuora, S. Anti-TNF agents go head-to-head. Nat Rev Rheumatol 13, 2 (2017). https://doi.org/10.1038/nrrheum.2016.206
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DOI: https://doi.org/10.1038/nrrheum.2016.206