Optimizing Glucocorticoid Therapy in Rheumatoid Arthritis

Antonio, Paulo; Bijlsma, J. W. J.

doi:10.1016/s0889-857x(05)70173-3

Cited by 22 publications

(2 citation statements)

References 76 publications

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“…Earp et al 2008 reported that AIA can be treated with dexamethasone, and that the inflammatory process of the disease did not alter the clearance or the volume distribution of dexamethasone when compared with the healthy controls. In addition there is growing evidence for the positive effect of low dose glucocorticoids on the retardation of erosive damage (Da Silva and Bijlsma 2000).…”

Section: Figmentioning

confidence: 99%

Effect of orexin-A (hypocretin-1) on hyperalgesic and cachectic manifestations of experimentally induced rheumatoid arthritis in rats

Mohamed

El-Hadidy

2014

Can. J. Physiol. Pharmacol.

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Section: Figmentioning

confidence: 99%

Effect of orexin-A (hypocretin-1) on hyperalgesic and cachectic manifestations of experimentally induced rheumatoid arthritis in rats

Mohamed

El-Hadidy

2014

Can. J. Physiol. Pharmacol.

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“…In addition to disease-modifying anti-rheumatic drugs (DMARDs) and to recently introduced biologicals (for example, antibodies against tumor necrosis factor- (TNF)-α or soluble TNF-α-receptors, [8-14]), anti-inflammatory glucocorticoids are still frequently employed to bridge the gap before the onset of action of DMARDs [15-17] and to improve the therapeutic control of RA. Due to their unequalled efficacy, bridging application and wide indication range (for example, renal failure, pregnancy), glucocorticoids remain valuable therapeutic tools.…”

Section: Introductionmentioning

confidence: 99%

Liposomal encapsulation enhances and prolongs the anti-inflammatory effects of water-soluble dexamethasone phosphate in experimental adjuvant arthritis

et al. 2010

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IntroductionThe objective of this study was to evaluate the efficacy of intravenous (i.v.) injection of liposomally encapsulated dexamethasone phosphate (DxM-P) in comparison to free DxM-P in rats with established adjuvant arthritis (AA). This study focused on polyethylene glycol (PEG)-free liposomes, to minimize known allergic reactions caused by neutral PEG-modified (PEG-ylated) liposomes.MethodsEfficacy was assessed clinically and histologically using standard scores. Non-specific and specific immune parameters were monitored. Activation of peritoneal macrophages was analyzed via cytokine profiling. Pharmacokinetics/biodistribution of DxM in plasma, synovial membrane, spleen and liver were assessed via mass spectrometry.ResultsLiposomal DxM-P (3 × 1 mg/kg body weight; administered intravenously (i.v.) on Days 14, 15 and 16 of AA) suppressed established AA, including histological signs, erythrocyte sedimentation rate, white blood cell count, circulating anti-mycobacterial IgG, and production of interleukin-1beta (IL-1β) and IL-6 by peritoneal macrophages. The suppression was strong and long-lasting. The clinical effects of liposomal DxM-P were dose-dependent for dosages between 0.01 and 1.0 mg/kg. Single administration of 1 mg/kg liposomal DxM-P and 3 × 1 mg/kg of free DxM-P showed comparable effects consisting of a partial and transient suppression. Moreover, the effects of medium-dose liposomal DxM-P (3 × 0.1 mg/kg) were equal (in the short term) or superior (in the long term) to those of high-dose free DxM-P (3 × 1 mg/kg), suggesting a potential dose reduction by a factor between 3 and 10 by liposomal encapsulation. For at least 48 hours after the last injection, the liposomal drug achieved significantly higher levels in plasma, synovial membrane, spleen and liver than the free drug.ConclusionsThis new PEG-free formulation of macrophage-targeting liposomal DxM-P considerably reduces the dose and/or frequency required to treat AA, with a potential to enhance or prolong therapeutic efficacy and limit side-effects also in the therapy of rheumatoid arthritis. Depot and/or recirculation effects in plasma, inflamed joint, liver, and spleen may contribute to this superiority of liposomally encapsulated DxM-P.

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Energy Balance and Neuroendocrine-Immune Regulation in Chronic Inflammatory and Neoplastic Diseases: An Evolutionary Perspective

Konsman

Straub

2023

Masterclass in Neuroendocrinology

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Optimizing Glucocorticoid Therapy in Rheumatoid Arthritis

Cited by 22 publications

References 76 publications

Effect of orexin-A (hypocretin-1) on hyperalgesic and cachectic manifestations of experimentally induced rheumatoid arthritis in rats

Effect of orexin-A (hypocretin-1) on hyperalgesic and cachectic manifestations of experimentally induced rheumatoid arthritis in rats

Liposomal encapsulation enhances and prolongs the anti-inflammatory effects of water-soluble dexamethasone phosphate in experimental adjuvant arthritis

Energy Balance and Neuroendocrine-Immune Regulation in Chronic Inflammatory and Neoplastic Diseases: An Evolutionary Perspective

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