New biologics in the management of Crohn’s disease: focus on certolizumab pegol

Crohn's disease (CD) is a chronic inflammatory condition involving the gastrointestinal tract characterized by recurrent exacerbations and remission. The disease frequently occurs in the lower part of the small bowel, but can affect any part of the digestive tract, from the mouth to the anus. The traditional goals of treatment of Crohn's disease were to induce and maintain clinical remission. More recently targets such as mucosal healing, reduced hospitalization and surgery, and improved quality of life are becoming increasingly achievable. The general principles for treatment should consider clinical activity, site and behavior of disease; however, the appropriate choice of medication depends on many factors that are the best tailored to the individual patient. This review focuses on certolizumab pegol, the first Fc-free PEGylated Fab' fragment of humanized monoclonal antibody that binds and neutralizes human tumor necrosis factor alpha. Data on indication, pharmacokinetics, efficacy, safety, and influence on quality of life are reviewed.