Hyaluronic acid coated teriflunomide (A771726) loaded lipid carriers for the oral management of rheumatoid arthritis

Systemic rheumatoid arthritis treatment has been associated with numerous side effects. We attempted to formulate hyaluronic acid (HA)-coated teriflunomide (TER)-loaded nanostructured lipid carriers (NLCs) that can target inflamed rheumatic joints following oral administration. In vitro evaluation including colloidal characteristics, drug release and stability studies were conducted. Also, cytotoxicity studies on THP1 and peripheral blood mononuclear cells besides testing the binding of HA coated TER-NLCs to CD44 receptors were carried out. Furthermore, pharmacokinetics following oral administration, anti-arthritic effects, hepato and nephrotoxicity of NLCs were assessed. Selected NLCs formulation was approximately 284.9 ± 3.8 nm in size with 96.89 ± 0.45% entrapment efficiency and provided a sustained release for 30 days. NLCs showed good stability that was confirmed by TEM examination. Cell culture studies revealed that HA-coated TER- NLCs showed superior cytotoxicity and binding affinity to CD44 receptors compared with TER suspension. In vivo studies demonstrated the superiority of NLCs in increasing TER bioavailability, reducing TNF-α serum levels and improving joint healing that was evidenced in both histopathological and X-ray radiographic examination. This may be attributed to the ability of HA-coated TER-NLCs to target rheumatic joints passively and actively by targeting CD44 receptors that are overexpressed in rheumatic joints.