Francis James Thomas Fildes

Novel treatment for joint inflammation.

THE use of liposomes in the entrappment and administration of several therapeutic agents has been described for the treatment of cancer1 and heavy metal poisoning2, and in enzyme replacement therapy3. The advantages of a liposome drug over the use of free or polymer-bound agent are decreased toxicity and degradation, the use of smaller doses and the possibility of targeting the liposome towards a given tissue or site4. The localised administration of therapeutic agents, such as the intra-articular injection of cortisol esters in the treatment of rheumatoid arthritis5, is a situation where the use of liposomes as a means of providing a stable particulate suspension of entrapped steroid might be used to advantage. This method should reduce considerably the effective dose required to produce relief, and diminish side effects due to escape of steroid from the joint6. We report here that the treatment of an acute experimental arthritis in the rabbit with a liposome preparation containing cortisol results in a significant reduction in joint temperature and diameter, whereas treatment with an equivalent amount of cortisol alone, or with liposomes lacking cortisol, does not reduce these two parameters of inflammation.