Nanoparticulate drug delivery systems for the treatment of rheumatoid arthritis: A comprehensive review

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease that affects 1% of the world's population. It is a progressive condition that causes joint inflammation, polyarticular synovitis, bone and cartilage destruction, bone erosion, and deformation, resulting in impairments, morbidity, and a lower quality of life. There is no curative therapy for rheumatoid arthritis because the complete pathogenesis is unknown. The treatment aim is to give symptomatic relief while preventing irreversible joint injury. The standard treatment involves glucocorticoids alone or in combination with nonbiologic and biologic disease-modifying anti-rheumatoid drugs (DMARDs). Treatment of RA with conventional dosage forms has limitations such as non-specificity, dose-escalation, increased frequency of administration, toleration, and systemic side effects. Through its application to medicine, nanotechnology has been able to address the drawbacks of conventional treatment and the complexity of the disease, thus offering new possibilities for the treatment of RA by achieving specificity to joints through active and passive targeting strategies, overcoming dose escalation, increased frequency of administration, and the adverse effects associated with it. This review entails a thorough understanding of various Nanoparticulate drug delivery systems, including polymeric nanoparticles such as polymeric micelles, nanocapsules, and dendrimers; lipid-based nanoparticles such as liposomes, solid lipid nanoparticles, nanostructured lipid carriers, Transferosomes, exosomes, nanoemulsions, ethosomes; and metallic nanoparticles such as gold and silver nanoparticles, quantum dots, siRNA, and peptide-based nanoparticulate delivery systems. A comprehensive review of the merits and drawbacks of nanoparticulate drug delivery systems is provided, as well as an update on their application in the pharmacotherapy, toxicity, clinical trial of Nanoparticles on rheumatoid arthritis, and patents granted in this field.