MahfoozurRahman
DepartmentofPharmaceuticalSciences,ShalomInstituteofhealthandalliedsciences,SHUATS,Allahabad,India
SarwarBeg
UniversityInstituteofPharmaceuticalSciences,Panjab,University,Chandigarh,India
FirozAnwar
DepartmentofBiochemistry,FacultyofScience,KingABDulazizUniversity,Jeddah,KingdomofSaudiArABIa
VikasKumar
DepartmentofPharmaceuticalSciences,ShalomInstituteofhealthandalliedsciences,SHUATS,Allahabad,India
RaisuddinAli
DepartmentofPharmaceuticsandCentralLab,CollegeofPharmacy,KingSaudUniversity,Riyadh,KingdomofSaudiArabia
SohailAkhter
LeStudiumLoireValleyInstituteforAdvancedStudies,Centre-ValdeLoire,France;CentredeBiophysiqueMoléculaire,CentreNationaldelaRechercheScientifique,UnitéPropredeRecherche4301,Orléans,FranceABSTRACT

Rheumatoidarthritis(RA)isaverypainfulsevereautoimmunediseasewithcomplexpathologycharacterizedbyprogressivechronicinflammation,anddevastationofthesynovium,cartilage,andotherjoint-associatedstructures.Significantadvancesinresearchintheareaofpathophysiology,diagnosis,drugdevelopment,andtargeteddeliveryhaveledtoimprovedRAtherapyandbetterpatientcompliance.TargeteddrugdeliveryusingLiposomalnanomedicinessignificantlyalleviatethechallengeswithconventionalanti-RAmedicationssuchasoff-targeteffects,shortBIOLOGicalhalf-life,poorbioavailability,highdose-relatedtoxicity,etc.LiposomalnanomedicinesinRAdrugtargetingoffertheopportunityforpassivetargetingbasedonsizeandpolyethyleneglycol(PEG)-ylation-mediatedenhancedpermeabilityandretentionandactivetargeting(ligationwithantibodyorpeptides,etc.)andencapsulationoflipophilic,hydrophilicdrugs,and/orcombinationaldrugs.However,ithasbeenfoundrecentlythatsuchinjectablenanomedicinesraisetheconcernofanadverseimmunephenomenoncalledcomplementactivationrelatedpseudoallergy(CARPA)andfailureoftherapyonmultipledosesduetoacceleratedbodyclearancecausedmanybyanti-PEGimmunoglobulinM.ToensuresafetyandefficacyofRAtherapy,theseneedtobeconsideredalongwiththecommonformulationqualityparameters.Here,wediscussnanotherapeutictargetinginRAtherapyusingliposomes.Liposomalnanoparticlesareinvestigatedforindividualanti-RAdrugcategories.CARPAissuesandpathophysiologywithsuchnanomedicinesarealsodiscussedindetail.KEYWORDS:rheumatoidarthritis,liposomes,stealthliposome,magnetoliposome,cationicliposomes,corticosteroids,drugtargeting,CARPA