Progress in intra-articular therapy

Christopher H Evans, Virginia B. Kraus, Lori A. Setton

Research output: Contribution to journalArticle

129 Citations (Scopus)

Abstract

Diarthrodial joints are well suited to intra-articular injection, and the local delivery of therapeutics in this fashion brings several potential advantages to the treatment of a wide range of arthropathies. Possible benefits over systemic delivery include increased bioavailability, reduced systemic exposure, fewer adverse events, and lower total drug costs. Nevertheless, intra-articular therapy is challenging because of the rapid egress of injected materials from the joint space; this elimination is true of both small molecules, which exit via synovial capillaries, and of macromolecules, which are cleared by the lymphatic system. In general, soluble materials have an intra-articular dwell time measured only in hours. Corticosteroids and hyaluronate preparations constitute the mainstay of FDA-approved intra-articular therapeutics. Recombinant proteins, autologous blood products and analgesics have also found clinical use via intra-articular delivery. Several alternative approaches, such as local delivery of cell and gene therapy, as well as the use of microparticles, liposomes, and modified drugs, are in various stages of preclinical development.

Original languageEnglish (US)
Pages (from-to)11-22
Number of pages12
JournalNature Reviews Rheumatology
Volume10
Issue number1
DOIs
StatePublished - Jan 2014
Externally publishedYes

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Joints
Therapeutics
Intra-Articular Injections
Lymphatic System
Drug Costs
Joint Diseases
Cell- and Tissue-Based Therapy
Recombinant Proteins
Liposomes
Genetic Therapy
Biological Availability
Analgesics
Adrenal Cortex Hormones
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Rheumatology

Cite this

Progress in intra-articular therapy. / Evans, Christopher H; Kraus, Virginia B.; Setton, Lori A.

In: Nature Reviews Rheumatology, Vol. 10, No. 1, 01.2014, p. 11-22.

Research output: Contribution to journalArticle

Evans, Christopher H ; Kraus, Virginia B. ; Setton, Lori A. / Progress in intra-articular therapy. In: Nature Reviews Rheumatology. 2014 ; Vol. 10, No. 1. pp. 11-22.
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