Maximizing Intra-Articular Therapy for Osteoarthritis and other Joint Diseases: Continuous Infusion Device for Prolonged Drug-Target Residence Time

Author(s): Sergio Crimaldi, Paolo Mario Sarais, Antonio Devito, Alberto Migliore

Intra-articular injections in the management of Osteoarthritis, offer notable advantages such as enhanced bioavailability. However, despite resorting to intra-articular injection as a direct method for local administration, free drugs often struggle to linger within the joint space for sufficient periods. This struggle compromises the achievement of their biological objectives at a consistently satisfactory level and duration. Since the main determinant for intra-articular drug administration in osteoarthritic joints is pharmacokinetics, we propose a new medical device to maintain a constant level of product inside the joint. This is an infusion pump with permanent catheter into the joint, specifically designed for intra-articular infusion and capable of administering articular products continuously over time. The potential advantages of this pump can be: prolongation of residence time of therapeutics (ranging from a few hours to several days); ensuring the correct dose; avoiding the use of crystals for "depo" effect; instantaneous modulation of administration speed; transportability and wearability, eliminating the need for hospitalization. However further studies are needed to confirm the safety of the use of this articular pump infusion and to determine correct indications, appropriate products and proper volume and dosage to administer in each clinical case.