From the Research
Switching a patient from Orencia (abatacept) to Cimzia (certolizumab pegol) should be considered on a case-by-case basis, taking into account the patient's specific medical history, current disease status, reason for considering the switch, and previous treatment responses, as there is no one-size-fits-all answer to this question. The decision to switch between these two biologics should be based on several factors, including the patient's response to Orencia, presence of adverse effects, or development of antibodies against the medication. Both medications work differently - Orencia is a T-cell co-stimulation modulator while Cimzia is a TNF inhibitor - so they may have different efficacy profiles for individual patients.
Before switching, it's essential to evaluate the patient's current disease activity, comorbidities, infection risk, and pregnancy status (as Cimzia has better pregnancy safety data) 1. Additionally, insurance coverage and patient preference regarding administration method (Orencia can be given IV or subcutaneously, while Cimzia is subcutaneous only) should be considered. A washout period between medications may be necessary to reduce infection risk. This decision should be made collaboratively between you, the patient, and potentially a rheumatologist if you're not one yourself.
Some key points to consider when evaluating Cimzia as an alternative include its efficacy in treating various immune-mediated inflammatory diseases, including rheumatoid arthritis, axial spondyloarthritis, psoriatic arthritis, and moderate to severe plaque psoriasis, as demonstrated in several studies 2, 3, 4, 1. The medication has been shown to improve clinical signs and symptoms of disease, health-related quality of life, and productivity in patients with these conditions. However, the tolerability profile of Cimzia, including the risk of infections and other adverse events, must also be taken into account 2, 3, 5.
Given the most recent and highest quality evidence available, the switch to Cimzia may be a viable option for patients who are not responding adequately to Orencia or experiencing adverse effects, particularly in light of Cimzia's unique pharmacokinetic properties and its potential benefits in certain patient populations, such as women of childbearing age 1. Ultimately, the decision to switch medications should prioritize the patient's morbidity, mortality, and quality of life outcomes.