Certolizumab pegol in severe rheumatoid arthritis: Real-world evidence in an Argentine cohort: Achievement of targets (T2T) at 3 months and predictive factors.

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Introduction: Certolizumab pegol (CTZ) is a tumor necrosis factor-alpha (TNF-α) inhibitor biological agent that has demonstrated efficacy in controlling rheumatoid arthritis (RA). Identifying predictive factors for treatment success and assessing its effectiveness in a real-world clinical setting are crucial for decision-making. Objective: To evaluate the response to CTZ in patients with RA in a real-world cohort, measuring the reduction in DAS 28, HAQ, frequency of remission, and low disease activity (LDA) at three months, identifying predictive factors, and evaluating the reduction in the use of corticosteroids. Methods: A prospective real-world observational study included patients over 18 years of age with RA (ACR/EULAR 2010 criteria) who initiated CTZ and were followed for three months. Demographic, clinical, comorbidity, treatment, and disease activity data were recorded. Results: Out of 2092 RA patients treated with CTZ between 2016 and 2021, 90% had a poor prognosis, and 60% had high disease activity. Among 1673 patients followed for three months, a reduction in DAS 28 (-1.9) and HAQ (-0.63) was observed. At three months, 10.5% achieved remission, and 40% achieved LDA. Predictive factors for remission included age (OR: 0.97) and DAS 28 (OR: 0.58); for LDA, age (OR: 0.97), DAS 28 (OR: 0.61), first-line CTZ (OR: 1.6), and HAQ (OR: 0.61). Additionally, there was a reduction in the use of glucocorticoids (-3.1 mg prednisone). Conclusions: CTZ is effective in RA, emphasizing patient selection and an early treatment approach. This study supports the efficacy of CTZ.