Intra-articular drug delivery systems for the treatment of rheumatic diseases: a review of the factors influencing their performance

Eur J Pharm Biopharm. 2009 Oct;73(2):205-18. doi: 10.1016/j.ejpb.2009.06.009. Epub 2009 Jun 21.

Abstract

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.

Publication types

  • Review

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / administration & dosage*
  • Anti-Inflammatory Agents / adverse effects
  • Anti-Inflammatory Agents / chemistry
  • Antirheumatic Agents / administration & dosage*
  • Antirheumatic Agents / adverse effects
  • Antirheumatic Agents / chemistry
  • Arthritis, Rheumatoid / drug therapy*
  • Arthritis, Rheumatoid / pathology
  • Chemistry, Pharmaceutical
  • Delayed-Action Preparations
  • Drug Carriers*
  • Drug Compounding
  • Humans
  • Injections, Intra-Articular
  • Joints / drug effects*
  • Joints / pathology
  • Kinetics
  • Osteoarthritis / drug therapy*
  • Osteoarthritis / pathology
  • Particle Size
  • Solubility

Substances

  • Anti-Inflammatory Agents
  • Antirheumatic Agents
  • Delayed-Action Preparations
  • Drug Carriers