Rheumatoid arthritis (RA) is a type of arthritis that is considered an autoimmune disease. An autoimmune disease is when your immune system starts attacking your body. It causes pain and swelling in your joints. Cimzia is an injectable medication that is approved to help with RA symptoms.
How Does Cimzia Work for RA?
The active ingredient in Cimzia is certolizumab pegol. It belongs to a class of medications called tumor necrosis factor alpha (TNFα) blockers. TNFα works in the body to cause inflammation. When this is blocked by Cimzia, inflammation decreases, and RA symptoms improve.
How Do I Use Cimzia?
Cimzia is a liquid that is injected under the skin every 2 to 4 weeks. The dose and how often you use the medication will be determined by your health care provider. It can be injected into the thigh or stomach.
The medicine comes as a prefilled syringe that is ready to be injected under the skin. Your health care provider will show you how to inject the medicine before you use it for the first time. Read the instructions in detail. You can watch an instructional video on the drugmaker’s website at https://www.cimzia.com/injection-training. You can ask your pharmacist if you have any other questions.
How Was It Studied for RA?
For RA, four early studies were done to compare Cimzia to a placebo containing no medicine. The people in the studies did not know if they were getting Cimzia or the placebo. In order to be in the studies, people needed to have moderate to severe RA for more than 6 months, with nine or more swollen or tender joints. They also needed to have tried specific medicines to treat their RA in the past that did not control it completely.
In the first three studies, people had taken methotrexate for the last 6 months for their RA, but it didn’t work to control their symptoms. In the studies, they continued their methotrexate and added on Cimzia for their RA. The first study was the longest, at 52 weeks. Studies two and three were shorter and lasted for 24 weeks. The studies used slightly different dosage plans of Cimzia, but in all three studies, the results were similar. The number of people who saw improvement in their RA symptoms was higher when taking Cimzia with methotrexate, compared to methotrexate alone. These studies also showed that people who took Cimzia had greater improvements in their physical function.
In the fourth study, people had tried any medication used for RA, but it didn’t work to control their symptoms. In this study, people were given Cimzia by itself or a placebo containing no medicine. Similar to the other studies, the number of people who saw improvement in their RA symptoms was higher when taking Cimzia, and they had had greater improvements in their physical function.
Your results may differ from what was seen in clinical studies.
How Long Does It Take for It to Work?
Cimzia can start working within a few days. But a full response might not be seen until you have been taking Cimzia for about 5 weeks.Tell your health care provider if your RA symptoms do not improve. Consider keeping a symptoms diary to keep track of your symptoms and their consistency. This can help you and your health care provider find out how well your medicines are working for you.
How Can I Prevent and Manage Side Effects?
The most common side effects seen with Cimzia are infections, rash, certain types of cancers, heart failure, and blood disorders.
Infections. The most commonly reported infections were the common cold, upper respiratory tract infections, and urinary tract infections. Signs of the common cold and upper respiratory tract infections include fever, cough, and sore throat. Signs of a urinary tract infection, also known as a kidney or bladder infection, include fever, burning or stinging when you urinate, pain in the lower belly, and an urge to pee more often. Overall, Cimzia can increase your chances of having any infection. Be sure to tell your health care provider if you have a history of chronic infection, infection that keeps coming back, tuberculosis, or hepatitis B. Your health care provider will check for tuberculosis with a skin test before you start taking Cimzia. To lower your chances of getting an infection, make sure you are up to date with your vaccines. You should use good hygiene practices such as disinfecting surfaces, washing your hands, and avoiding touching your face. You should also avoid being in close contact with someone you know is sick and avoid large crowds. Call your health care provider right away if you think you might have an infection.
Cancer. Cimzia can increase the risk of certain types of cancers, including cancer of the lymph glands (lymphoma) and certain types of skin cancer. Symptoms may include swollen glands in the neck, armpit, or groin; cough; fever; weight loss; or skin changes. Call your health care provider right away if you have any of those symptoms. To protect your skin, you should wear sunscreen and protective clothing when you are in the sun, and you should also avoid tanning beds. You should check your skin routinely. If you see any new moles or ones that change in shape, color, or size, call your health care provider right away.
Heart failure. Cimzia may increase your risk of heart failure or worsen heart failure if you already have it. Symptoms of heart failure include shortness of breath, swelling in your feet or legs, weight gain, and tiredness. Tell your health care provider right away if you have any of these symptoms.
Blood disorders. Cimzia can cause blood disorders, such as aplastic anemia, low platelet levels (thrombocytopenia), low white blood cell levels (leukopenia), and a combination of low red blood cells, white blood cells, and platelets (pancytopenia). Signs of these disorders include fever, shortness of breath, pale or yellow skin, easy bleeding, frequent infection, and weakness. Your health care provider will monitor your blood regularly for these conditions. It is important you keep all your scheduled appointments for blood tests. If you have any symptoms of a blood disorder, you should call your health care provider right away.
Tell your health care provider if you are having any symptoms that bother you. If you experience anything that you think may be caused by Cimzia, you can also report side effects to the FDA at 800-FDA-1088 (800-332-1088).
What Kinds of Drug Interactions May Happen?
It is important for your health care provider to be aware of every medicine you are taking, especially medicines for RA, before you start using Cimzia.
Certain medicines: Cimzia should not be used with the following medicines because there is an increased risk of serious infections.
- Abatacept (Orencia), a medicine commonly used for RA and psoriatic arthritis
- Anakinra (Kineret), a medicine commonly used for RA
- Natalizumab (Tysabri), a medicine commonly used for Crohn’s disease or multiple sclerosis
- Rituximab (Rituxan), a medicine commonly used for RA and some cancers
Live vaccinations: Live vaccinations should be avoided while taking Cimzia. This is because the vaccination may not be as effective and can risk infection. Your health care provider will review your vaccination record before starting Cimzia and recommend any vaccinations at that time.
Lab tests: Cimzia has the potential to interfere with certain blood clotting tests. Tell your health care provider you are taking Cimzia before you get bloodwork to ensure there is no interaction.
Tell your pharmacist or other health care provider about all the prescription or over-the-counter (OTC) medicines, vitamins/minerals, herbal products, or other supplements you take or have recently taken. This will help them to determine the best treatment plan for you.
What Do I Need to Do to Get It, and What Kind of Doctor Prescribes It?
Cimzia is a “specialty” medicine. This means that your regular community pharmacy may not be able to fill the prescription for you. If that is the case, you can use a specialty pharmacy, which may ship the medicine to you. The medicine may require prior authorization from your insurance company.
Is There Any Cost Assistance Available?
There is a savings coupon available from the drugmaker that may allow you to pay $0 for your prescription. Whether you are eligible depends on whether you have prescription insurance, and what type of insurance you have. You can find out more at https://www.cimzia.com/co-pay.
