A Critical Analysis of Hydrogel Systems, Nanodrug Delivery, and Physical Modalities for Topical and Minimally Invasive Rheumatoid Arthritis Treatment

About ۰.۵-۱% of adults have rheumatoid arthritis (RA), an autoimmune inflammatory disease that causes joint destruction, chronic pain, and a lower quality of life, especially in those over ۴۰. Even though biologic agents and conventional synthetic disease-modifying antirheumatic medications (csDMARDs) are effective, some patients do not achieve long-term disease control, and there is still a lack of consistent data on new local and minimally invasive treatments. The purpose of this study was to critically examine the data regarding the safety and effectiveness of topical and minimally invasive treatments for RA, such as magnetotherapy, therapeutic ultrasound, hydrogel and nanodrug delivery systems, and extracorporeal shock wave therapy (ESWT). Human and animal studies that were indexed in major scientific databases were the subject of a systematic/narrative review. The studies were extracted based on the type of intervention and study design, and descriptive and inferential methods were used to compare them. According to the review, injectable hydrogels and nanosystems decreased cartilage degradation and joint inflammation in animal models. A small single-center randomized controlled trial (RCT) with ۳۲ participants found that magnetotherapy improved functional indices and reduced pain. With few significant side effects, physical modalities like ESWT and ultrasound typically resulted in short-term clinical improvement. For middle-aged and older RA patients, combining systemic therapies with local and minimally invasive procedures seems to be a promising approach; however, large, long-term RCTs are still required to validate these results and establish ideal protocols. No new ethics committee approval or additional informed consent was needed because this review only used published data and did not directly involve patient or animal interventions.

کلیدواژه ها:

Rheumatoid arthritis ، disease-modifying antirheumatic drugs (DMARDs) ، drug delivery systems ، hydrogels ، therapeutic ultrasound ، magnetotherapy