A promising new treatment being developed for inflammatory arthritis -- which includes rheumatoid arthritis and psoriatic arthritis -- responds to flare-ups in real time.
In experiments carried out at Brigham and Women's Hospital (BWH), bioengineers have developed a soft, flexible material that can be loaded with arthritis drugs and injected locally into an inflamed joint.
Instead of delivering the drug continuously at a steady rate, the hydrogel is designed to respond to increased disease activity during flares, releasing the drug when symptoms worsen, the hospital explained.
The findings of the research have been published in Nature Communications.
"Arthritis represents a huge unmet clinical need," said co-senior author Jeff Karp, a bioengineer and principal investigator at BWH. "Although new therapeutics have been developed, many have had systemic, toxic effects. We wanted to design a delivery system that could be efficient, deliver drugs locally and release drugs in response to inflammation."
The flare-responsive hydrogel is made from triglycerol monostearate (TG-18), and in the study it was loaded with an anti-inflammatory compound known as triamcinolone acetonide (TA). Release of the drug is triggered by the activity of specific, arthritis-related enzymes that are increased during flares.
This would allow patients to be treated specifically in the joints where the disease is flaring, rather than delivering a drug throughout the body.
"Local therapy could be a viable treatment option for patients with only one or a few inflamed joints," said co-corresponding author Joerg Ermann, a rheumatologist in the BWH Division of Rheumatology, Immunology and Allergy. "Moreover, if a patient is already on a systemic drug but is experiencing a flare in a limited number of joints, we could specifically treat these joints rather than switching systemic therapy or adding another systemic drug. Having this option would substantially increase our ability to successfully manage arthritis flares in the clinic."
Further tests will be conducted in preclinical models before the hydrogel advances to human clinical trials.