Window of opportunity in axial spondyloarthritis: A Stitch in Time

Axial spondyloarthritis comprising both non-radiographic axial spondyloarthritis and ankylosingspondylitis has a deleterious impact on the patient’s quality of life with a detrimental outcome ofstructural damage. Although in the current era of diagnostic advancements, axSpA can be diagnosedearly within a short period after the onset of symptoms, but still there is a delay of up to severalyears in many parts of the world. The concept of a window of opportunity is primarily derived fromrheumatoid arthritis, which is relevant in the context of axSpA based upon the early diagnosis and tocommence highly effective treatment with biologics like anti-TNF and anti-IL-17 to modify thedisease process for arresting structural damage or syndesmophytes formation. Still, challenges existfor early diagnosis of SpA in patients with low back pain which ultimately creates a barrier toeffective treatment initiation. More robust researches along with the available evidence on both theaspects of clinical and imaging factors are the way forward for the early identification of susceptibleindividuals for early intervention with a better outcome

Improvement of bone microarchitecture in methylprednisolone induced rat model of osteoporosis by using thiolated chitosan-based risedronate mucoadhesive film

Objective: In this study, we investigated the potential of thiolated chitosan-based mucoadhesive film, loaded with risedronate sodium in the treatment of osteoporosis. Significance: Risedronate sodium is a bisphosphonate derivative having very low bioavailability when administered through the oral route. Moreover, the adverse effects associated with the drug when administered through GIT necessitate an alternative and feasible route which can improve its bioavailability and therapeutic efficacy. Methods: Thiolation of chitosan was interpreted by different analytical techniques. The mucoadhesive films were prepared by the solvent evaporation method and evaluated for drug content analysis, swelling degree, mucoadhesive parameters, and permeation characterization. For the screening of preclinical efficacy and pharmacodynamic parameters, a methylprednisolone induced osteoporotic rat model was used. The trabecular microarchitecture and biochemical markers were evaluated for determination of bone resorption. Results: The different analytical characterization of synthesized thiolated chitosan revealed that chitosan was successfully incorporated with thiol groups. The formulation containing 2:1 ratio of thiolated chitosan and HPMC-4KM was found to have the maximum swelling degree, mucoadhesive strength with a good force of adhesion and better in vitro permeability compared to the marketed formulation. With respect to trabecular microarchitecture, the drug-loaded film formulation showed superior and promising results. Furthermore, the film formulation also improved the serum level of biomarkers better than the marketed formulation. Conclusions: The results significantly suggest that risedronate loaded novel mucoadhesive film formulation could be a logical approach in the therapeutic intervention of osteoporosis

Pamidronate functionalized mucoadhesive compact for treatment of osteoporosis-in vitro and in vivo characterization

The aim of the present study was to develop directly compressed compacts for mucoadhesive delivery of pamidronate disodium for the treatment of osteoporosis in the rat model induced by methylprednisolone. A blend of HPMC-4KM and thiolated chitosan was used as the biodegradable polymers for the formulation of mucoadhesive compacts. The drug-polymer characterization was done by different analytical techniques like FTIR, DSC, and XRD. Biochemical analysis, histopathology and SEM analysis of the trabecular region of the femur were done to confirm the induction and treatment of osteoporosis. The analytical characterization revealed the formation of polyelectrolyte complexes between the drug and polymer due to high compressional forces. Formulation T2 with thiolated chitosan/HPMC-4KM ratio of 0.5/1 showed superior swelling, mucoadhesive properties, and better drug release and was investigated for in vivo study. The compact formulation improved the serum biomarkers level and bone microarchitectural properties in the osteoporotic rats as revealed by histopathology and SEM analysis. The results indicated the potential use of thiolated polymer based mucoadhesive compacts as a rational tactic for osteoporosis therapy