Intra-articular drug delivery for arthritis diseases: the value of extended release and targeting strategies

The rationale behind the development of intra-articularly administered formulations is needed for the efficacious treatment of osteoarthritis and rheumatoid arthritis to minimize systemic side effects and to enhance drug availability at the site of action. The present review summarizes the major research with respect to intra-articularly administered arthritis treatments in the form of solutions, suspensions, particles, liposomes, hydrogels and targeted delivery systems. Other considerations, such as extended drug release, drug retention and localization to the joint and biodistribution are extensively discussed. In vivo models are also considered, illustrating the broad choice of animals and techniques that can be used to mimic human arthritis diseases. Retention and drug efficacy of up to several weeks have been reported following intra-articular administration of particles that are embedded in gels or administered as targeted drug delivery systems. Such approaches hold promise for the development of more effective and patient-friendly treatments of rheumatic disease.