Gouty Arthritis Treatment: Advancements in Topical Lipid-Based Nanocarrier Delivery Systems

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.