Kumar Shubham, Kaul Shreya, Jain Neha, Jain Chirag, Pandey Manisha
Centre for Pharmaceutics, Amity Institute of Pharmacy, Amity University, Noida, India.
Department of Industrial Pharmacy, Amity Institute of Pharmacy, Amity University, Noida, India.
Adv Pharm Bull. 2025 Apr 4;15(1):11-26. doi: 10.34172/apb.44012. eCollection 2025 Apr.
The formation of urate crystals in the joints causes severe, erratic flare-ups of joint pain, swelling, and erythema in gout, one kind of inflammatory arthritis. The standard treatment currently available involves the use of nonsteroidal anti-inflammatory drugs (NSAIDs), colchicine, allopurinol, febuxostat, and corticosteroids which require lifelong management via oral or parenteral route. The challenge is the therapy adherence as the symptoms become better, patients may quit taking them, which could result in more episodes. In addition, conventional therapy regimes demonstrate insufficient effectiveness and minimal safety owing to these drug molecule's biopharmaceutical limitations, including inadequate chemical stability and an insufficient capacity to target the pathophysiological pathways. Therefore, developing an alternative drug carrier system that can meet the challenge is necessary. In recent years, the use of lipid-based nanocarriers has increased due to their properties of enhancing solubility and bioavailability of poor-soluble drugs, site-specific targeting, and sustained release. In this review, an attempt has been made to highlight the challenges of available therapies for gout along with its pathophysiology, the mechanism of lipoidal nanocarriers permeation via topical route, and recent advancements in gout therapy using lipid nanocarriers based on preclinical experiments. In addition, patents and clinical trials of lipid-based nanocarriers have also been discussed. Lipid-based nanocarriers present a potential strategy specifically for topical gout therapy as this can offer localized therapy with minimal systemic exposure. Even though lipid-based nanocarriers show promise for gout topical therapy, several issues that need to be looked after, including economically viable scalability and regulatory approvals.
在痛风（一种炎症性关节炎）中，关节处尿酸盐晶体的形成会导致关节疼痛、肿胀和红斑严重且反复突然发作。目前可用的标准治疗方法包括使用非甾体抗炎药（NSAIDs）、秋水仙碱、别嘌醇、非布司他和皮质类固醇，这些药物需要通过口服或肠胃外途径进行终身治疗。挑战在于治疗依从性，因为症状好转后患者可能会停止服药，这可能导致更多发作。此外，由于这些药物分子的生物制药局限性，包括化学稳定性不足和靶向病理生理途径的能力不足，传统治疗方案的有效性不足且安全性有限。因此，开发一种能够应对这一挑战的替代药物载体系统是必要的。近年来，基于脂质的纳米载体的使用有所增加，这是由于它们具有提高难溶性药物的溶解度和生物利用度、位点特异性靶向和持续释放的特性。在本综述中，我们试图强调痛风现有疗法面临的挑战及其病理生理学、脂质纳米载体经皮渗透的机制，以及基于临床前实验的脂质纳米载体在痛风治疗中的最新进展。此外，还讨论了基于脂质的纳米载体的专利和临床试验。基于脂质的纳米载体为痛风局部治疗提供了一种潜在策略，因为这可以在最小程度的全身暴露下提供局部治疗。尽管基于脂质的纳米载体在痛风局部治疗方面显示出前景，但仍有几个问题需要关注，包括经济上可行的可扩展性和监管批准。
