Anti-inflammatory drugsAnti-inflammatory drugs constitute the backbone of treatment for most diseases. In fact, there is a direct relationship between chronic inflammation and many emerging disorders like cancer, oral diseases, kidney diseases, fibromyalgia, GI chronic diseases or rheumatic diseases [1]. Steroidal anti-inflammatory drugs (SAIDs) and nonsteroidal antiinflammatory drugs (NSAIDs) are key contributors in the treatment of acute inflammatory pain conditions such as headache, postoperative pain and orthopedic fractures as well as in the management of chronic inflammatory pain and inflammatory diseases like rheumatoid arthritis, osteoarthritis and gout and for ocular diseases [2]. The principal therapeutic applications of NSAIDs are related to pain, fever and they can also be used as a prophylaxis treatment after first coronary or cerebrovascular ischemic event, this is one of the most important usages of acetylsalicylic acid (ASA) [3]. Principal therapeutic areas for SAIDs are allergic rhinitis (nasally administered) [4], asthma [5], nasal polyposis and chronic rhinosinusitis [6,7]. Orally administered prednisolone, a SAID, is indicated in bronchial asthma, allergic and inflammatory disorders, rheumatoid arthritis and other collagenopathies, dermatitis and dermatoses such as subacute and chronic eczema, psoriasis and pemphigus.
Worldwide anti-inflammatory drug consumptionNowadays, anti-inflammatory medications are one of the most consumed type of drugs worldwide. According to the commercial source of drug utilization IQVIA [8] in 2019, ASA, diclofenac (DIC) and ibuprofen were the three main NSAIDs consumed worldwide. From September 2018 to September 2019, more than 335,000 million standard units or doses were sold. NSAIDs consumption is reported to be a bit higher than SAIDs. The leading market share of NSAIDs and SAIDs market is located in Europe and southeast Asia.In Europe, the market is dominated by NSAIDs, with sales of ASA, DIC and ibuprofen exceeding 12,000 million standard units a year and 16,000 million in the case of ASA. SAIDs also represent a huge market in Europe, among them (in decreasing order) mometasone, beclomethasone, fluticasone and the combination of beclomethasone and formoterol.Concerning the delivery routes of the three most consumed SAIDs worldwide mometasone, fluticasone and prednisolone, the nasal route is predominant (54.7%), followed by the oral (21.6%) and ophthalmic routes (9.9%), but it depends on the drug. These data refer to the year 2019 [8].
Limitations of convectional anti-inflammatory therapiesUnfortunately, current anti-inflammatory therapies are unable to achieve the best conditions of efficacy and safety. It is also important to highlight that anti-inflammatory drugs lead to very expensive and serious adverse events, Nanomedicine (Lond.