The Therapeutic Landscape of Rheumatoid Arthritis: Current State and Future Directions

Rheumatoid arthritis (RA) is a debilitating autoimmune disease with grave physical, emotional and socioeconomic consequences. Despite advances in targeted biologic and pharmacologic interventions that have recently come to market, many patients with RA continue to have inadequate response to therapies, or intolerable side effects, with resultant progression of their disease. In this review, we detail multiple biomolecular pathways involved in RA disease pathogenesis to elucidate and highlight pathways that have been therapeutic targets in managing this systemic autoimmune disease. Here we present an up-to-date accounting of both emerging and approved pharmacological treatments for RA, detailing their discovery, mechanisms of action, efficacy, and limitations. Finally, we turn to the emerging fields of bioengineering and cell therapy to illuminate possible future targeted therapeutic options that combine material and biological sciences for localized therapeutic action with the potential to greatly reduce side effects seen in systemically applied treatment modalities.

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Antibody modified gold nanoparticles for fast colorimetric screening of rheumatoid arthritis

The Analyst ◽

10.1039/c9an00319c ◽

2019 ◽

Vol 144 (11) ◽

pp. 3613-3619 ◽

Cited By ~ 5

Author(s):

Bruno Veigas ◽

Ana Matias ◽

Tomás Calmeiro ◽

Elvira Fortunato ◽

Alexandra R. Fernandes ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Gold Nanoparticles ◽

Autoimmune Disease ◽

Joint Inflammation ◽

Systemic Autoimmune Disease ◽

Ageing Population ◽

Chronic Disability ◽

High Prevalence

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic joint inflammation and one of the main causes of chronic disability worldwide with high prevalence in the ageing population.

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Rheumatoid Arthritis: A Brief Overview of the Treatment

Medical Principles and Practice ◽

10.1159/000493390 ◽

2018 ◽

Vol 27 (6) ◽

pp. 501-507 ◽

Cited By ~ 18

Author(s):

Jacqueline Bullock ◽

Syed A.A. Rizvi ◽

Ayman M. Saleh ◽

Sultan S. Ahmed ◽

Duc P. Do ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Risk Factors ◽

Air Pollutants ◽

Joint Damage ◽

Treatment Modalities ◽

Systemic Autoimmune Disease ◽

Treatment Goals ◽

Rheumatoid Vasculitis ◽

Present Treatment ◽

Felty Syndrome

Rheumatoid arthritis (RA) is a chronic, inflammatory, systemic autoimmune disease, affecting the joints with varying severity among patients. The risk factors include age, gender, genetics, and environmental exposure (cigarette smoking, air pollutants, and occupational). Many complications can follow, such as permanent joint damage requiring arthroplasty, rheumatoid vasculitis, and Felty syndrome requiring splenectomy if it remains unaddressed. As there is no cure for RA, the treatment goals are to reduce the pain and stop/slow further damage. Here, we present a brief summary of various past and present treatment modalities to address the complications associated with RA.

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Current Therapeutic Options in the Treatment of Rheumatoid Arthritis

Journal of Clinical Medicine ◽

10.3390/jcm8070938 ◽

2019 ◽

Vol 8 (7) ◽

pp. 938 ◽

Cited By ~ 17

Author(s):

Köhler ◽

Günther ◽

Kaudewitz ◽

Lorenz

Keyword(s):

Rheumatoid Arthritis ◽

Autoimmune Disease ◽

Disease Activity ◽

Physical Function ◽

Chronic Inflammation ◽

Early Treatment ◽

Joint Destruction ◽

Therapeutic Options ◽

Systemic Autoimmune Disease ◽

Control Disease

Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation of the joints. Untreated RA leads to a destruction of joints through the erosion of cartilage and bone. The loss of physical function is the consequence. Early treatment is important to control disease activity and to prevent joint destruction. Nowadays, different classes of drugs with different modes of action are available to control the inflammation and to achieve remission. In this review, we want to discuss differences and similarities of these different drugs.

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Rheumatoid Arthritis: Pathogenic Roles of Diverse Immune Cells

International Journal of Molecular Sciences ◽

10.3390/ijms23020905 ◽

2022 ◽

Vol 23 (2) ◽

pp. 905

Author(s):

Sunhee Jang ◽

Eui-Jong Kwon ◽

Jennifer Jooha Lee

Keyword(s):

Rheumatoid Arthritis ◽

T Cells ◽

Autoimmune Disease ◽

Immune Cells ◽

Cartilage Destruction ◽

Systemic Autoimmune Disease ◽

Pannus Formation ◽

Systemic Complications ◽

Tissue Proliferation ◽

Novel Therapeutic

Rheumatoid arthritis (RA) is a chronic, systemic autoimmune disease associated with synovial tissue proliferation, pannus formation, cartilage destruction, and systemic complications. Currently, advanced understandings of the pathologic mechanisms of autoreactive CD4+ T cells, B cells, macrophages, inflammatory cytokines, chemokines, and autoantibodies that cause RA have been achieved, despite the fact that much remains to be elucidated. This review provides an updated pathogenesis of RA which will unveil novel therapeutic targets.

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Diagnosis of rheumatoid arthritis

Spravočnik vrača obŝej praktiki (Journal of Family Medicine) ◽

10.33920/med-10-2003-03 ◽

2020 ◽

pp. 29-36

Author(s):

Lev Shlopak

Keyword(s):

Rheumatoid Arthritis ◽

Autoimmune Disease ◽

Connective Tissue ◽

Early Diagnosis ◽

Inflammatory Diseases ◽

Primary Lesion ◽

Systemic Autoimmune Disease ◽

Chronic Inflammatory Diseases

Rheumatoid arthritis is a chronic systemic autoimmune disease of the connective tissue, accompanied by a primary lesion of peripheral joints with the development of erosive-destructive changes and ankylosis. It is one of the most common chronic inflammatory diseases in humans. Early diagnosis of this pathology contributes to the timely start of therapy, which allows to reduce the level of disability and improve the prognosis for this group of patients.

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Mast Cells in Early Rheumatoid Arthritis

International Journal of Molecular Sciences ◽

10.3390/ijms20082040 ◽

2019 ◽

Vol 20 (8) ◽

pp. 2040 ◽

Cited By ~ 7

Author(s):

Felice Rivellese ◽

Francesca Wanda Rossi ◽

Maria Rosaria Galdiero ◽

Costantino Pitzalis ◽

Amato de Paulis

Keyword(s):

Rheumatoid Arthritis ◽

Innate Immunity ◽

Mast Cells ◽

Autoimmune Disease ◽

Animal Models ◽

Immune Cells ◽

Systemic Autoimmune Disease ◽

Disease Development ◽

Early Ra ◽

Contradictory Data

Rheumatoid arthritis (RA) is a chronic systemic autoimmune disease characterized by inflammation of the synovial membrane, with thickening of the synovial layer, cellular hyperplasia, and infiltration of immune cells. Mast cells (MCs) are cells of the innate immunity present in healthy synovia and part of the cellular hyperplasia characterizing RA synovitis. Although their presence in synovia has been well described, the exact functions and the correlation of MCs with disease development and progression have been debated, particularly because of contradictory data obtained in animal models and from patients with longstanding disease. Here, we present a revision of the literature on MCs in RA, including the most recent observations obtained from patients with early RA, indicating MCs as relevant markers of disease severity in early RA.

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ROLE OF PANCHAKARMA IN MANAGEMENT OF RHEUMATOID ARTHRITIS

International Journal of Advanced Research ◽

10.21474/ijar01/12662 ◽

2021 ◽

Vol 9 (04) ◽

pp. 122-126

Author(s):

Panchola Priyanka ◽

◽

Joshi Neha ◽

Deepshikha a ◽

Garg G.P ◽

...

Keyword(s):

Rheumatoid Arthritis ◽

Autoimmune Disease ◽

Systemic Disease ◽

Modern Science ◽

Body Part ◽

The Body ◽

Systemic Autoimmune Disease ◽

Loss Of Function ◽

Abnormal Immune Response

Rheumatoid arthritis is a systemic autoimmune disease that causes chronic inflammation of the joints.It causes inflammation of the tissue around the joints. As the disease advancement, the inflamed synovium occupies and damages the cartilage and bone of the joint. An autoimmune disease is a condition characterized by an abnormal immune response to a normal body part. Because it can affect various organs of the body, rheumatoid arthritis is referred to as a systemic disease and ultimately called rheumatoid disease. In Ayurvedaamavata is correlated with rheumatoid arthritis. Vitiatedvata and ama plays major role in the manifestation of amavata. Improper digestion of Rasaadidhatu leads to the formation of ama. Vitiated ama leads swelling, pain, stiffness, in many joints along with loss of function. Modern science does not offer any cure of RA, the management aims are limited. This article reviews the line of treatment for the management of amavata described by Acharyachakradatta. It was concluded that rheumatoid arthritis can be completely cured or treated with Ayurveda medication and Panchakarma therapies without any side effects.

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Virtual Screening of Natural Metabolites as Candidate Drugs for Rheumatoid Arthritis

International Journal of Recent Technology and Engineering - 2 ◽

10.35940/ijrte.d1069.1284s419 ◽

2020 ◽

Vol 8 (4S4) ◽

pp. 226-230

Keyword(s):

Rheumatoid Arthritis ◽

Side Effects ◽

Autoimmune Disease ◽

Virtual Screening ◽

Membrane Protein ◽

Drug Target ◽

Biological Response ◽

Chemical Compounds ◽

Novel Drug ◽

Autodock 4.2

Inflammation is a complex biological response to reject and heal any harmful stimuli created by pathogens, damaged cells or irritants. One of the more prevalent inflammatory disease found in 0.5-1.0% of the world’s population is Rheumatoid arthritis (RA). RA is an autoimmune disease affecting the synovia. The actual reason for this disease is still unknown and is more complex to study. So, the drugs which are commercialized acts only to reduce the outcome of the disease, pain, by inhibiting the vital enzymes responsible for the synthesis of inflammatory mediators called prostaglandins. Cyclooxygenase- I and Cyclooxygenase- II are the commonly targeted enzymes by the current drugs in market. These drugs are reported to affect the normal physiological functions of various organs leading to side effects. PGE2 is the major prostaglandin involved in this disorder and found abundant in the affected synovia. mPGES- I is a membrane protein involved in the biosynthesis of PGE2 which has been reported as a novel drug target to treat RA. Though synthesized chemical compounds have higher anti-inflammatory activity; they are reported to possess a number of side effects. Thus a library of natural compounds are collected and screened virtually as mPGES-1 inhibitors using Autodock 4.2.

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Stimuli-responsive Drug Delivery Systems as an Emerging Platform for Treatment of Rheumatoid Arthritis

Current Pharmaceutical Design ◽

10.2174/1381612825666190321104424 ◽

2019 ◽

Vol 25 (2) ◽

pp. 155-165 ◽

Cited By ~ 1

Author(s):

Xiao-Ling Xu ◽

Kong-Jun Lu ◽

Xiao-Qin Yao ◽

Xiao-Ying Ying ◽

Yong-Zhong Du

Keyword(s):

Rheumatoid Arthritis ◽

Drug Delivery ◽

Side Effects ◽

Drug Delivery Systems ◽

Drug Exposure ◽

Redox Status ◽

Considerable Effect ◽

Delivery Systems ◽

Systemic Autoimmune Disease ◽

Stimuli Responsive

Rheumatoid Arthritis (RA) is a systemic autoimmune disease accompanied by chronic inflammation. Due to the long-term infiltration in inflammatory sites, joints get steadily deteriorated, eventually resulting in functional incapacitation and disability. Despite the considerable effect, RA sufferers treated with current drug therapeutic efficacy are exposed to severe side effects. Application of Drug Delivery Systems (DDS) has improved these situations while the problem of limited drug exposure remains untackled. Stimuli-responsive DDS that are responsive to a variety of endogenous and exogenous stimuli, such as pH, redox status, and temperature, have emerged as a promising therapeutic strategy to optimize the drug release. Herein, we discussed the therapeutic regimes and serious side effects of current RA therapy, as well as focused on some of the potential stimuliresponsive DDS utilized in RA therapy. Besides, the prospective room in designing DDS for RA treatment has also been discussed.

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Targeted Nanomedicine to Treat Bone Metastasis

Pharmaceutics ◽

10.3390/pharmaceutics10040205 ◽

2018 ◽

Vol 10 (4) ◽

pp. 205 ◽

Cited By ~ 11

Author(s):

Isaac Adjei ◽

Madison Temples ◽

Shannon Brown ◽

Blanka Sharma

Keyword(s):

Side Effects ◽

Bone Metastasis ◽

Bone Metastases ◽

Drug Targeting ◽

State Of The Art ◽

Treatment Modalities ◽

Pathological Fractures ◽

Current State ◽

Skeletal Related Events ◽

New Treatment

Bone metastases are common complications of solid tumors, particularly those of the prostate, breast, and lungs. Bone metastases can lead to painful and devastating skeletal-related events (SREs), such as pathological fractures and nerve compressions. Despite advances in treatment for cancers in general, options for bone metastases remain inadequate and generally palliative. Anticancer drugs (chemotherapy and radiopharmaceuticals) do not achieve therapeutic concentrations in the bone and are associated with dose-limiting side effects to healthy tissues. Nanomedicines, with their tunable characteristics, have the potential to improve drug targeting to bone metastases while decreasing side effects for their effective treatment. In this review, we present the current state of the art for nanomedicines to treat bone metastases. We also discuss new treatment modalities enhanced by nanomedicine and their effects on SREs and disease progression.

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