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Progress in intra-articular therapy.

Publication ,  Journal Article
Evans, CH; Kraus, VB; Setton, LA
Published in: Nat Rev Rheumatol
January 2014

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.

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Published In

Nat Rev Rheumatol

DOI

EISSN

1759-4804

Publication Date

January 2014

Volume

10

Issue

1

Start / End Page

11 / 22

Location

United States

Related Subject Headings

  • Time Factors
  • Rheumatic Diseases
  • Injections, Intra-Articular
  • Humans
  • Antirheumatic Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Adrenal Cortex Hormones
  • 1103 Clinical Sciences
 

Citation

APA
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ICMJE
MLA
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Evans, C. H., Kraus, V. B., & Setton, L. A. (2014). Progress in intra-articular therapy. Nat Rev Rheumatol, 10(1), 11–22. https://doi.org/10.1038/nrrheum.2013.159
Evans, Christopher H., Virginia B. Kraus, and Lori A. Setton. “Progress in intra-articular therapy.Nat Rev Rheumatol 10, no. 1 (January 2014): 11–22. https://doi.org/10.1038/nrrheum.2013.159.
Evans CH, Kraus VB, Setton LA. Progress in intra-articular therapy. Nat Rev Rheumatol. 2014 Jan;10(1):11–22.
Evans, Christopher H., et al. “Progress in intra-articular therapy.Nat Rev Rheumatol, vol. 10, no. 1, Jan. 2014, pp. 11–22. Pubmed, doi:10.1038/nrrheum.2013.159.
Evans CH, Kraus VB, Setton LA. Progress in intra-articular therapy. Nat Rev Rheumatol. 2014 Jan;10(1):11–22.

Published In

Nat Rev Rheumatol

DOI

EISSN

1759-4804

Publication Date

January 2014

Volume

10

Issue

1

Start / End Page

11 / 22

Location

United States

Related Subject Headings

  • Time Factors
  • Rheumatic Diseases
  • Injections, Intra-Articular
  • Humans
  • Antirheumatic Agents
  • Anti-Inflammatory Agents, Non-Steroidal
  • Adrenal Cortex Hormones
  • 1103 Clinical Sciences