Summary of certolizumab pegol in psoriasis including structural features, pharmacokinetics and treatment

Psoriasis pathogenesis involves TNF-alpha, IL-23 and IL17, against which biologics have been highly effective. Among the five TNF-alpha inhibitors available for psoriasis, namely infliximab, adalimumab, etanercept, golimumab and certolizumab pegol (CZP), CZP has a unique mechanism of action due to its structure. As CZP lacks the Fc region, it does not cross the placenta and can be safely used in pregnant women. Its PEGylated nature allows for longer distribution time in tissues, potentially leading to a longer-lasting effect compared with other TNF-alpha inhibitors. In clinical trials, the efficacy of CZP on psoriasis skin symptoms and joint symptoms was comparable to other TNF-alpha inhibitors, with no discernible differences in safety profiles. Plain language summary: Psoriasis is a skin condition that affects the skin and causes joint problems. There are some medicines called TNF-alpha inhibitors that work well, especially for the joint issues. There are currently five TNF-alpha inhibitors available for treating psoriasis. One of these, certolizumab pegol, is different from the others. It lacks a specific part, which makes it less likely to pass through the placenta. This means it's safer for pregnant and breastfeeding women. Clinical trials have shown that certolizumab pegol is just as effective as other TNF-alpha inhibitors for treating the skin and joint symptoms of psoriasis. It's also equally safe. Psoriasis pathogenesis involves TNF-alpha, IL-23 and IL17. Certolizumab pegol (CZP), lacking the Fc region, does not cross the placenta and can be safely used in pregnant women. Clinical data of CZP in psoriasis demonstrate high efficacy in skin and joint symptoms.