My Experience on Cimzia During Pregnancy and Postpartum
I did my first set of Cimzia injections when I was almost 32 weeks pregnant with my second child. My inflammation levels were out of control and one specialist refused to provide treatment for my disease, but thankfully, I had a wonderful maternal-fetal doctor who advocated for my rheumatologist to prescribe Cimzia. This medication is frequently regarded as the safest biologic for autoimmune diseases during pregnancy because it has very low to undetectable levels of transfer across the placenta.1
What is Cimzia?
Cimzia (certolizumab pegol) is a monoclonal antibody that attacks a protein called tumor necrosis factor (TNF). By blocking TNF, Cimzia reduces inflammation and helps with symptoms like joint pain, stiffness, and fatigue. This process also suppresses your immune system.
Cimzia must remain cold until it’s ready to be used in order to do its job correctly. A set of syringes is delivered to my home every month inside a styrofoam cooler filled to the brim with gel packs. I let the syringes thaw for 30 minutes before injecting because it's less painful, but it's important to use them shortly after thawing.
Doing the self-injections
I’ve been on Cimzia for 4 months and I’ve done 6 sets of injections (each injection is 2 syringes). The first 3 injections were 2 weeks apart because they were loading doses, and the next 3 injections were 4 weeks apart, which is the typical dosing schedule. Next week I’ll be doing my 7th set of injections and I’m looking forward to it because I’ve had such good disease control with no noticeable side effects – which I’ve never been able to say about a medication before!
Even though I’ve had no side effects to speak of, I have experienced injection site reactions. The injections should be done into your thighs or stomach and I generally prefer thighs (though it’s important to alternate injection sites). I get a stinging sensation and occasionally a welt for an hour or so afterward in the area where I inject the medication. For the next couple of days, I usually have small bruises and a lighter circle of skin, 3-4 inches wide, in the spot where the medication went in. I don’t feel any pain from these and only discovered them because I happened to see them after a shower one day.
One great thing about this injection is that it comes in an arthritis-friendly syringe – it was developed in partnership with OXO Good Grips® to be easier for patients to use. Though I do it at home, you can go to your rheumatologist’s office for injections, especially for the first one.
How Cimzia has helped me
I was amazed at how quickly my joint pain decreased after starting Cimzia. With most medications, it takes 3 to 6 months for them to fully kick in and for any side effects to subside. But the joint pain in my fingers decreased within about 3 weeks and I was able to use my hands normally again. This was life-changing for my quality of life as I prepared for a newborn while caring for my 3-year-old.
When my rheumatologist prescribed Cimzia, she also ran tests for Sjögren’s syndrome due to some intense dryness and inflammation in my eyes and mouth. Some of the tests came back positive and, fortunately, I saw an improvement in my eye inflammation after starting Cimzia.
When I gave birth, I had only been on Cimzia for 5 weeks, but my symptoms remained largely under control. (I delivered my baby at 37 weeks, but it was not because of my autoimmune issues; it was due to a rare genetic condition inherited from his father.) I had a larger baby, almost 8 pounds at birth, and I was able to pick up him pretty easily as my joint pain remained under control.
I could hardly believe how well things were going since after my first pregnancy I could barely hold my 6-pound baby due to pain in my fingers. The first time, I had an awful postpartum flare at 6 weeks (this is very common for people with lupus and RA), but after my second pregnancy, I felt very good for about 10 weeks. My two postpartum experiences were worlds apart thanks to having my lupus and Sjögren’s syndrome under better control.
I have started to experience a gradual increase in symptoms, and I may have to add on treatment or change meds to prevent a flare. But I’m so grateful for this season where I’ve had controlled joint pain with basically no side effects thanks to this fantastic biologic. My body seems to have accepted this medication better than any other one so far.
While Cimzia is not a standard treatment for lupus – I was only able to get coverage because of my pregnancy and Sjögren's syndrome - I’ve had such great success with it. I hope that it will increasingly be considered as a treatment for lupus.
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