Anti-TNF therapy in Crohn's disease: A balance between a targeted therapeutic approach and drug-induced immunogenicity

Evaluation of: Schreiber S, Khaliq-Kareemi M, Laurence IC et al.; PRECISE 2 Study Investigators. Maintenance therapy with certolizumab pegol for the treatment of Crohn's disease. N. Engl. J. Med. 357, 239–250 (2007). Crohn's disease is a chronic idiopathic inflammatory bowel disorder with no known cure. Patients generally require drug therapy over their lifetime in order to induce and maintain disease remission and an improved quality of life. Although anti-TNF therapies have proven efficacy in the treatment of patients with Crohn's disease, not all patients respond, while others show a loss of efficacy over time on maintenance therapy. The risk for immunogenicity with certain forms of anti-TNF therapy has led to the development of novel biologics, including certolizumab pegol. This paper evaluates the results of a large randomized placebo-controlled trial with certolizumab pegol in the maintenance (26 weeks) of remission in patients with moderate-to-severe Crohn's disease.