Intra-articular drug delivery systems for the treatment of rheumatic diseases: a review of the factors influencing their performance.
Osteoarthritis and rheumatoid arthritis are rheumatic diseases for which a curative treatment does not currently exist. Their management is directed towards pain relief achieved with different classes of drugs among which non-steroidal and steroidal anti-inflammatory substances are the most frequently used agents. Nevertheless, the oral or systemic administration of such drugs is hindered by numerous side effects, which could be overcome by their intra-articular (i-a.) administration as dosage forms capable of gradually releasing the active substance. The present review article summarises the research done in the field of drug delivery systems for i-a. injection vs. current management of osteoarthritis or rheumatoid arthritis. Aspects such as the influence of size, shape, polymer matrix or targeted drug on the i-a. retention time, phagocytosis and biological activity will be discussed. Finally, we will comment on the need for adapted delivery systems for the novel and very potent anti-inflammatory drugs, such as inhibitors of the p38 mitogen-activated protein kinase or the IL-1beta conversion enzyme, which to date cannot be properly used due to the severe side effects associated with their systemic administration.
Butoescu
N
N
School of Pharmaceutical Sciences, University of Geneva, Geneva, Switzerland.
Jordan
O
O
Doelker
E
E
D000818:Animals; D000893:Anti-Inflammatory Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects / Q000737:chemistry; D001172:Arthritis, Rheumatoid / Q000188:drug therapy* / Q000473:pathology; D002626:Chemistry, Pharmaceutical; D003692:Delayed-Action Preparations; D004337:Drug Carriers; D004339:Drug Compounding; D006801:Humans; D007270:Injections, Intra-Articular; D007596:Joints / Q000187:drug effects* / Q000473:pathology; D007700:Kinetics; D010003:Osteoarthritis / Q000188:drug therapy* / Q000473:pathology; D010316:Particle Size; D012995:Solubility
D000893:Anti-Inflammatory Agents; D018501:Antirheumatic Agents; D003692:Delayed-Action Preparations; D004337:Drug Carriers