Patients on immunosuppressive therapy have an increased risk of infections. Since infections have a potential to trigger acute porphyric attacks vigilance is motivated regarding signs or symptoms of infection and/or possible symptoms of a porphyric attack. Side effects like gastrointestinal discomfort and nausea may potentially be porphyrinogenic through reduction in carbohydrate intake.

Infections are common in patients using immunosuppressants and since infections might trigger an acute porphyric attack, vigilance regarding signs and symptoms of an infection and/ or a porphyric attack is recommended. Common adverse reactions of certolizumab pegol that can be confused with an acute porphyric attack are gastrointestinal discomfort and nausea. These side effects may potentially be porphyrinogenic if leading to a decrease in carbohydrate intake.

Certolizumab pegol is an antibody preparation not metabolized by CYP enzymes. No pharmacokinetic porphyrinogenic effects are suspected.

Certolizumab pegol is a recombinant, humanised antibody Fab fragment against tumour necrosis factor alpha expressed in Escherichia coli and conjugated to polyethylene glycol (PEG).

Certolizumab pegol is a biologic response modifier used in the treatment of moderately to severely active rheumatoid arthritis, progressive psoriatic arthritis and Crohns disease. It is administered subcutaneously.

The Fab protein component is degraded to peptides and amino acids by proteolysis. Certolizumab pegol is not metabolized by hepatic cytochrome P-450 (CYP) enzymes. The elimination half-life og certolizumab pegol is about 14 days.