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Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation of the joints and bone destruction. Because of systemic administration and poor targeting, traditional anti‐rheumatic drugs have unsatisfactory treatment efficacy and strong side effects, including myelosuppression, liver or kidney function damage, and malignant tumors. Consequently, mesenchymal stem cells (MSCs)‐involved therapy is proposed for RA therapy as a benefit of their immunosuppressive and tissue‐repairing effects. This review summarizes the progress of MSCs‐involved RA therapy through suppressing inflammation and promoting tissue regeneration and predicts their potential clinical application. [ABSTRACT FROM AUTHOR]

Designing a theranostic probe for noninvasive bone imaging and bone disease therapy is both challenging and desirable. Herein, an ultrasmall Au nanocluster (NC, <2 nm)‐based theranostic probe is developed to achieve highly temporospatial in vivo bone‐targeted photoluminescence (PL) imaging in the second near‐infrared window (NIR‐II) and enhanced rheumatoid arthritis (RA) therapy. The key design of the probe involves the surface phosphorylation of atomically precise NIR‐II emitting Au44 NCs. This phosphorylation enhances the bone‐targeting ability of the probe due to the highly concentrated phosphate groups, allowing the probe to realize in vivo bone‐targeted NIR‐II PL imaging. Moreover, benefiting from the enhanced bone‐targeting ability, ultrasmall hydrodynamic diameter, and excellent anti‐inflammation and immunomodulatory effects, the probe not only demonstrates superior therapeutic efficacy for RA rats, effectively restoring the destructed cartilage to nearly normal but also exhibits good renal clearance and benign biocompatibility. These favorable attributes cannot be achieved by commercial methotrexate used for RA treatment. This study presents a new design paradigm for metal NC‐based theranostic probes, offering the potential for high‐resolution bone‐targeted PL imaging and improved RA therapy. [ABSTRACT FROM AUTHOR]

Abstract Rheumatoid arthritis (RA) is a systemic autoimmune disease characterized by chronic inflammation of the joints and bone destruction. Because of systemic administration and poor targeting, traditional anti‐rheumatic drugs have unsatisfactory treatment efficacy and strong side effects, including myelosuppression, liver or kidney function damage, and malignant tumors. Consequently, mesenchymal stem cells (MSCs)‐involved therapy is proposed for RA therapy as a benefit of their immunosuppressive and tissue‐repairing effects. This review summarizes the progress of MSCs‐involved RA therapy through suppressing inflammation and promoting tissue regeneration and predicts their potential clinical application.

Abstract Designing a theranostic probe for noninvasive bone imaging and bone disease therapy is both challenging and desirable. Herein, an ultrasmall Au nanocluster (NC,

Objective: This study was aimed to analyze the prescription pattern of disease modifying anti-rheumatic drug (DMARD) therapy in patients with rheumatoid arthritis (RA) in a tertiary care teaching hospital in Uttarakhand, India. Methodology: This cross-sectional study was conducted in 150 RA patients who were given DMARD therapy. Patient's demographic details, drugs prescribed with their dosage and administration routes and the usage of complementary and alternative medicine (CAM) therapy were recorded to study the prescription pattern. Results: Overall, 4 DMARDs were prescribed in all the studied patients: Methotrexate (n = 150), hydroxychloroquine (n = 35), leflunomide (n = 5), and adalimumab (n = 1). Single DMARD therapy with methotrexate was prescribed to 110 (73.3%) followed by double therapy with methotrexate + hydroxychloroquine in 35 (23.3%), triple therapy (methotrexate + hydroxychloroquine + leflunomide) in 4 (2.7%) and triple therapy with biological DMARD (methotrexate + hydroxychloroquine + leflunomide + adalimumab) in 1 (0.7%) patient. Adjuvant therapy drugs included: Prednisolone (n = 150), folic acid (n = 150), naproxen (n = 150), calcium (n = 150), vitamin D (n = 150) and indomethacin (n = 40). Of the total, 61.4% patients also took complimentary alternative medicine (CAM) therapy. Conclusion: Our study concludes that the most commonly prescribed DMARDs in our setting, to patients of RA, in descending order of frequency were methotrexate, followed by hydroxychloroquine, leflunomide and lastly adalimumab. A total of five adjuvant medications were commonly prescribed to all patients. There was a high prevalence of self-medicated CAM therapy in the majority of these patients.

Objective: This study was aimed to analyze the prescription pattern of disease modifying anti-rheumatic drug (DMARD) therapy in patients with rheumatoid arthritis (RA) in a tertiary care teaching hospital in Uttarakhand, India. Methodology: This cross-sectional study was conducted in 150 RA patients who were given DMARD therapy. Patient's demographic details, drugs prescribed with their dosage and administration routes and the usage of complementary and alternative medicine (CAM) therapy were recorded to study the prescription pattern. Results: Overall, 4 DMARDs were prescribed in all the studied patients: Methotrexate (n = 150), hydroxychloroquine (n = 35), leflunomide (n = 5), and adalimumab (n = 1). Single DMARD therapy with methotrexate was prescribed to 110 (73.3%) followed by double therapy with methotrexate + hydroxychloroquine in 35 (23.3%), triple therapy (methotrexate + hydroxychloroquine + leflunomide) in 4 (2.7%) and triple therapy with biological DMARD (methotrexate + hydroxychloroquine + leflunomide + adalimumab) in 1 (0.7%) patient. Adjuvant therapy drugs included: Prednisolone (n = 150), folic acid (n = 150), naproxen (n = 150), calcium (n = 150), vitamin D (n = 150) and indomethacin (n = 40). Of the total, 61.4% patients also took complimentary alternative medicine (CAM) therapy. Conclusion: Our study concludes that the most commonly prescribed DMARDs in our setting, to patients of RA, in descending order of frequency were methotrexate, followed by hydroxychloroquine, leflunomide and lastly adalimumab. A total of five adjuvant medications were commonly prescribed to all patients. There was a high prevalence of self-medicated CAM therapy in the majority of these patients. [ABSTRACT FROM AUTHOR]

Poly(ethylene glycol)-crosslinked multimeric C60 was developed for use in photothermal/photodynamic therapy of malignant cells. We showed that: (i) the tumor surface temperature on KB tumor-bearing nude mice treated with multimeric C60 reached about 44 °C; (ii) this hyperthermic condition and tremendous singlet oxygen generation from multimeric C60 resulted in significant tumor volume regression in KB tumor-bearing nude mice; and (iii) multimeric C60 also efficiently inhibited arthritic progress in the arthritis-induced DBA/1 J mice model. This multimeric C60 may be useful for photothermal/photodynamic cell ablation in various malignant cells. Copyright © 2012 John Wiley & Sons, Ltd. [ABSTRACT FROM AUTHOR]

Background: Rheumatoid arthritis (RA) has unclear pathogenesis, but the molecules that feed its inflammatory state are known. Small interfering RNAs (siRNAs) are useful to identify molecular targets and evaluate the efficacy of specific drugs, and can themselves be used for therapeutic purposes., Sources of Data: A systematic search of different databases to March 2022 was performed to define the role of siRNAs in RA therapy. Twenty suitable studies were identified., Areas of Agreement: Small interfering RNAs can be useful in the study of inflammatory processes in RA, and identify possible therapeutic targets and drug therapies., Areas of Controversy: Many genes and cytokines participate in the inflammatory process of RA and can be regulated with siRNA. However, it is difficult to determine whether the responses to siRNAs and other drugs studied in human cells in vitro are similar to the responses in vivo., Growing Points: Inflammatory processes can be affected by the gene dysregulation of siRNAs on inflammatory cytokines., Areas Timely for Developing Research: To date, it is not possible to determine whether the pharmacological response of siRNAs on cells in vitro would be similar to what takes place in vivo for the diseases studied so far., (© The Author(s) 2022. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com.)

Rheumatoid arthritis (RA) induces the destruction of cartilage and bone. Methotrexate (MTX) functions as an effective first-line drug to relieve RA in the clinic. However, patients treated with MTX often suffer from severe side effects mainly due to its off-target effects. Therefore, selective delivery of MTX to the affected joints may achieve upregulated efficacy and safety. The affected joints of RA feature hypoxic microenvironment and increased level of glutathione (GSH), resulting from synovial proliferation, lymphocyte infiltration, and neovascularization. In this study, a disulfide-cross-linked nanogel (NG) of methoxy poly(ethylene glycol)-poly(L-phenylalanine- co -L-cystine) (mPEG-P(LP- co -LC)) was synthesized as an intracellular delivery system of MTX. The loading nanogel NG/MTX exhibited apparent reduction-responsiveness and GSH-triggered release behavior of MTX. It also showed efficient internalization and high cytotoxicity toward activated macrophages. Moreover, NG/MTX possessed selective biodistribution in the inflammatory joints of collagen-induced arthritis mouse model. The clinical and histological scores of the mice after NG/MTX treatment were lower than those of the other groups, and the progress of collagen-induced arthritis was overall relieved. To conclude, the controlled delivery of MTX by smart polymer nanoparticles to the RA-affected joints may be a promising approach in the clinical therapy of RA.

A new anti-tumor necrosis factor alpha (TNF-α) inhibitor with a novel mechanism of action has entered phase 3 trials in rheumatoid arthritis (RA). Certolizumab pegol (Cimzia(®)) is a humanized Fab' antibody fragment against TNF-α with a polyethylene glycol tail that prevents complement-dependent and antibody-dependent cell-mediated cytotoxicity or apoptosis. Four randomized clinical trials have been published so far. Reported results are similar to those published in previous studies with other TNF-α inhibitors, with ACR20, ACR50, and ACR70 responses of around 60%, 40%, and 20%, respectively, when combined with methotrexate and slightly lower when used as monotherapy. Safety was shown to be similar to that seen with TNF-α blockers and some cases of tuberculosis were seen in the trials, stressing the importance of a complete screening in these patients. Although we still need effectiveness and safety data in larger numbers of patients and longer follow-up, this new TNF inhibitor is a welcome addition to our current armamentarium for the treatment of RA.