Trojan horses and guided missiles: targeted therapies in the war on arthritis

Nature Reviews. Rheumatology
Mathieu FerrariCostantino Pitzalis

Abstract

Despite major advances in the treatment of rheumatoid arthritis (RA) led by the success of biologic therapies, the lack of response to therapy in a proportion of patients, as well as therapy discontinuation owing to systemic toxicity, are still unsolved issues. Unchecked RA might develop into progressive structural joint damage, loss of function and long-term disability, disorders which are associated with a considerable health-economic burden. Therefore, new strategies are required to actively target and deliver therapeutic agents to disease sites in order to promote in situ activity and decrease systemic toxicity. Polymer-drug conjugates can improve the pharmacokinetics of therapeutic agents, conferring desirable properties such as increased solubility and tissue penetration at sites of active disease. Additionally, nanotechnology is an exciting modality in which drugs are encapsulated to protect them from degradation or early activation in the circulation, as well as to reduce systemic toxicity. Together with the targeting capacity of antibodies and site-specific peptides, these approaches will facilitate selective accumulation of therapeutic agents in the inflamed synovium, potentially improving drug efficacy at disease sit...Continue Reading

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Citations

Apr 19, 2015·International Immunopharmacology·Yu-Ren ZhouJian-Xin Li
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Sep 29, 2020·Advanced Drug Delivery Reviews·Dinorath Olvera, Michael G Monaghan
Oct 27, 2021·Expert Opinion on Drug Delivery·Lucas C DunsheeKristi L Kiick

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