Title:Methotrexate in the Treatment of Psoriasis and Rheumatoid Arthritis: Mechanistic Insights, Current Issues and Novel Delivery Approaches
Volume: 23
Issue: 24
Author(s): Panonnummal Rajitha, Raja Biswas*, Mangalathillam Sabitha*R. Jayakumar*
Affiliation:
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Amrita University, Kochi- 682041,India
- Amrita School of Pharmacy, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Amrita University, Kochi-682041,India
- Amrita Centre for Nanosciences and Molecular Medicine, Amrita Institute of Medical Sciences and Research Centre, Amrita Vishwa Vidyapeetham, Amrita University, Kochi- 682041,India
Keywords:
Methotrexate, psoriasis, rheumatoid arthritis, colloidal carriers, immune modulatory activities, niosomal gel, hydrogel.
Abstract: Our review is focused on the use of methotrexate in drug therapy of two autoimmune diseases, psoriasis
and rheumatoid arthritis (RA). The article describes the pathogenesis of psoriasis and RA, the role of
methotrexate in the treatment of these diseases with more focused review on the mechanism behind the clinical
benefits of methotrexate therapy. Methotrexate due to its cytotoxic, anti-inflammatory and immune modulatory
activities provides clinical benefits in the therapy of the selected diseases. This review also gives a panorama of
the problems associated with the use of methotrexate in the selected diseases and the guidelines provided by FDA
for its safe use. The novel colloidal drug delivery systems of methotrexate, with particular emphasis on advantages
offered by liposomal formulation, niosomal gel, hydrogel, albumin conjugates, nanoparticles and nano
structured lipid carriers in psoriasis and RA are also reviewed. It seemed that the use of newer colloidal carriers
with improved skin permeability by minimizing its systemic availability will be a useful strategy to reduce the
toxic effects of the drug in psoriatic patients. In rheumatoid arthritis patients, the development of newer therapeutic
strategies using appropriate targeting ligands that specifically deliver the drug to the inflamed joint space will
help to overcome its toxic effects by minimizing the systemic exposure.
