Certolizumab Can Also Be Effective in Monotherapy for the Treatment of Rheumatoid Arthritis Patients.

20 Regarding disease progression, a study (C-OPERA) comparing a group of patients under CTZ+MTX combo versus a group of placebo + MTX patients showed a trend of greater modified Total Sharp Score change from baseline independently of positive titres of anti-CCP in both groups. 21 In another study comparing the efficacy of CTZ versus adalimumab, there were no baseline differences in anti-CCP positivity nor in the efficacy endpoints regarding the anti-CCP result. 22 This study has significant limitations inherent to its design, which implies a selection bias.

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However, these exploratory results show a clear trend of certolizumab being effective as monotherapy in patients previously treated with csDMARDs and even after being treated with one bDMARD.

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