Feature

DailyUpdates 8th April: An estimated 5 million individuals suffer from rheumatoid arthritis in the Western world.  Corticosteroids are the most dramatically effective short-term anti-inflammatory drugs; however, their clinical benefit for rheumatoid arthritis often diminishes with time. This, the severe rebounds observed following the withdrawal of corticosteroids, and long-term systemic side effects associated with corticosteroids limits their use in the treatment of rheumatoid arthritis.  Researchers have now shown that encapsulating steroids in liposomes results in their selective delivery to diseased joints.  This has been shown to facilitate less frequent dosing and may also increase efficacy and reduce side-effects.

Rheumatoid arthritis is one of the more common autoimmune diseases along with multiple sclerosis, type I diabetes and Crohn’s disease. Approximately one in five people in the western world suffer from autoimmune diseases and some estimates indicate that 75% of these are women. In total it is predicted that the annual value of the market for drugs used to treat autoimmune disease will soon exceed $20 billion. An estimated 5 million individuals suffer from rheumatoid arthritis, a figure which will increase to 5.7 million by 2010 (for further information on the rheumatoid arthritis market click here).

Corticosteroids are the most dramatically effective short-term anti-inflammatory drugs; however, their clinical benefit for RA often diminishes with time. Corticosteroids do not predictably prevent the progression of joint destruction, although a recent report suggested that they might slow erosions. Furthermore, severe rebound follows the withdrawal of corticosteroids in active disease. Because of their long-term systemic side effects, corticosteroids are usually given only after a careful and prolonged trial of less hazardous drugs.

Future directions for the development of rheumatoid arthritis therapeutics are ever focusing on disease modifying drug classes (LeadDiscovery's Rheumatoid arthritis: Emerging drug discovery targets and therapeutic candidates is recommended for readers requiring a full overview of DMARDs click here).  An alternate strategy however is the utilization of evolving drug delivery technology to target classic therapeutics such as the steroids to arthritic joints.

Source DailyUpdates 8th April; for a full abstract of the original papers see  Ann Rheum Dis. 2004 Apr;63(4):348-353

Recommended further reading:

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  Rheumatoid arthritis: Emerging drug discovery targets and therapeutic candidates


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  Rheumatoid Arthritis - DMARDs Gain Ground as Biologics Competition Intensifies


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  Advanced Drug Delivery: Technologies, Applications, and Markets

Of additional interest to the rheumatologist, Savient Pharmaceuticals today announced that it has initiated a Phase II clinical study of Puricase, a polyethylene glycol conjugate of uricase (urate oxidase), in the treatment of severe, refractory gout. For details of this release click here.