[Durgical](https://durgical.com/en/) › [DurgiPedia](https://durgical.com/en/durgipedia/) › [Pharmacology](https://durgical.com/en/pharmacology/) › [TNF inhibitors](https://durgical.com/en/pharmacology/classes/tnf-inhibitors/) › Certolizumab pegol [Pharmacology](https://durgical.com/en/pharmacology/) · [TNF inhibitors](https://durgical.com/en/pharmacology/classes/tnf-inhibitors/) # Certolizumab pegol An anti-TNF antibody fragment (Fab) attached to polyethylene glycol, injected under the skin for Crohn disease and inflammatory arthritis. Updated 2026-11-01 - Class: [TNF inhibitors](https://durgical.com/en/pharmacology/classes/tnf-inhibitors/) - Target: Tumour necrosis factor alpha (TNF-α) - ATC code: L04AB05 ◆**Tumour necrosis factor alpha (TNF-α)**Certolizumab pegol ⓘ The figure shows TNF-α bound to the certolizumab Fab (without its polyethylene glycol chain). **Target in 3D:** Tumour necrosis factor alpha (TNF-α). PDB structure 5WUX (RCSB PDB, public domain). [View the structure at RCSB PDB](https://www.rcsb.org/structure/5WUX) · Drag to rotate · pinch to zoom ## Mechanism of action Certolizumab pegol is a humanised Fab fragment against TNF-α linked to polyethylene glycol (PEG). It neutralises soluble and membrane TNF. Having no Fc portion, it does not fix complement or cause antibody-dependent cell killing; the PEG chain lengthens its time in the body. - Humanised Fab binds TNF-α - PEG chain makes it last longer - No Fc: no complement activation - TNF-driven inflammation falls ## Pharmacokinetics **Absorption** Subcutaneous injection **Metabolism** The Fab is broken down like other proteins; PEG is cleared separately ## Indications - Crohn disease [Crohn disease →](https://durgical.com/en/conditions/crohn-disease/) - Rheumatoid arthritis [Rheumatoid arthritis →](https://durgical.com/en/conditions/rheumatoid-arthritis/) - Psoriatic arthritis [Psoriatic arthritis →](https://durgical.com/en/conditions/psoriatic-arthritis/) - Ankylosing spondylitis and non-radiographic axial spondyloarthritis [Ankylosing spondylitis →](https://durgical.com/en/conditions/ankylosing-spondylitis/) - Plaque psoriasis [Psoriasis →](https://durgical.com/en/conditions/psoriasis/) ## Adverse effects ### Common - Upper respiratory infections - Injection-site reactions - Rash ### Serious (rare, important) - Serious infections (bacterial, viral, fungal and opportunistic) that can need hospital care or be fatal - Reactivation of latent tuberculosis or hepatitis B - Lymphoma and other cancers, including in children and young adults; hepatosplenic T-cell lymphoma in young people with inflammatory bowel disease - New or worse heart failure - Demyelinating disease (multiple sclerosis, optic neuritis, Guillain-Barré syndrome) - Lupus-like syndrome; low blood counts ## Contraindications - Active serious infection, including active tuberculosis - Hypersensitivity to certolizumab pegol ## Key interactions **Anakinra or abatacept** More serious infections without added benefit; not combined. **Live vaccines** Risk of infection by the vaccine strain; avoided during treatment. **Other immunosuppressants (glucocorticoids, methotrexate, azathioprine)** Additive risk of infection; azathioprine or mercaptopurine with a TNF blocker has been linked to hepatosplenic T-cell lymphoma. ## What is monitored - Latent tuberculosis test before starting, and watch for active TB during and after treatment even if the test was negative - Hepatitis B screening before starting - Signs of infection at every visit - Skin checks for cancer ## Administration and safety - Subcutaneous injection; rotate sites. - The prefilled syringe may contain latex: ask about latex allergy in the person and the one injecting. ## Nursing care - Confirm that the latent TB test and hepatitis B screening are done (and treated if positive) before the first dose. - Do not give the dose during an active infection; report fever, cough, night sweats or weight loss. - Check that vaccines are up to date before starting; live vaccines are avoided during treatment. - Ask about heart failure and neurological disease before starting. ## Pregnancy and breastfeeding The treating team weighs benefits and risks; the baby's doctor is told about exposure in pregnancy before any live vaccine. ## Memory aid CERTOlizumab PEGol: a Fab on a PEG — no Fc, no tail to wag. ## Test yourself Think of the answer, then tap the question to see it. ## What makes certolizumab pegol structurally different from other anti-TNF antibodies? It is only a humanised Fab fragment, with no Fc portion, attached to polyethylene glycol to lengthen its action. ## Does certolizumab pegol carry the same tuberculosis warning as other TNF inhibitors? Yes: latent TB and hepatitis B are screened before starting and infections are watched for throughout. ## Which bowel disease is an indication for certolizumab pegol? Crohn disease. [Add to my cards (3)](https://durgical.app/estudiar/?add=/en/pharmacology/certolizumab-pegol/) ## Related drugs - [Adalimumab](https://durgical.com/en/pharmacology/adalimumab/) - [Infliximab](https://durgical.com/en/pharmacology/infliximab/) - [Golimumab](https://durgical.com/en/pharmacology/golimumab/) - [Etanercept](https://durgical.com/en/pharmacology/etanercept/) ## Related conditions - [Crohn disease](https://durgical.com/en/conditions/crohn-disease/) - [Rheumatoid arthritis](https://durgical.com/en/conditions/rheumatoid-arthritis/) - [Psoriatic arthritis](https://durgical.com/en/conditions/psoriatic-arthritis/) - [Ankylosing spondylitis](https://durgical.com/en/conditions/ankylosing-spondylitis/) - [Psoriasis](https://durgical.com/en/conditions/psoriasis/) [← Back to the class: TNF inhibitors](https://durgical.com/en/pharmacology/classes/tnf-inhibitors/) Educational content on how drugs work; not a prescribing guide and no substitute for a health professional's advice. No doses are given. Sources: [Certolizumab Injection: MedlinePlus Drug Information](https://medlineplus.gov/druginfo/meds/a608041.html) (MedlinePlus (U.S. National Library of Medicine), 2024); Goodman & Gilman's The Pharmacological Basis of Therapeutics, 14th ed., ch. 39 (McGraw Hill, 2023); [ATCDDD - ATC/DDD Index](https://atcddd.fhi.no/atc_ddd_index/?code=L04AB05) (WHO Collaborating Centre for Drug Statistics Methodology, 2026). ## **Spotted a mistake?** We are always improving for the community. Tell us what is wrong and our team will review it. Report a mistake Representative model, for educational purposes only. --- Source: https://durgical.com/en/pharmacology/certolizumab-pegol/ License: CC BY 4.0 (https://creativecommons.org/licenses/by/4.0/). Cite as: DurgiPedia (durgical.com), https://durgical.com/en/pharmacology/certolizumab-pegol/