NSAIDs.

Arthritis is a form of joint disorder that involves inflammation in one or more joints. Most common form of arthritis is osteoarthritis and rheumatoid arthritis in which joint pain is the major symptom. Management of arthritis can be done by reliefing pain using various classes of drugs. Steroidal and non-steroidal anti-inflammatory agents (NSAIDs) are commonly used for treatment. NSAIDs nowadays are combined with other drugs for the better therapeutic effects compared to NSAIDs alone. Management of arthritis can be made using various drug delivery systems like polymeric drug delivery system, controlled drug delivery system, sustained delivery using various routes like oral, nasal and topical route etc. This review suggests management of arthritis using polymeric drug delivery system. Polymeric drug delivery systems are based on the chain link of polymers, and liposomes, hydrogels, nano devices are some of the approaches. Polymeric systems used in the treatment of inflammatory diseases and infections along with some other vaccines. Non-steroidal anti-inflammatory agents such as aspirin, ibuprofen, ketoprofen and diclofenac are used in the management and/or treatment of arthritis. This review also suggests the various drug candidates used to treat the arthritis.

Rheumatoid arthritis (RA) is an autoimmune disease that results in a chronic, systemic inflammatory disorder that may affect many tissues and organs, but principally attacks flexible (synovial) joints. It can be a disabling and painful condition, which can lead to substantial loss of functioning and mobility if not adequately treated. Conventional medicine treats rheumatoid arthritis with steroids and other immunosuppressive medications, most of which are toxic when used long-term. Patients who are dependent on them are now likely to respond to herbal products. Boswellia serrata (Shallaki) is mentioned as a pain remedy in ancient Sanskrit texts dating back thousands of years. The herb is recommended in treating rheumatoid arthritis, osteoarthritis, gout, joint pain, skeletal muscle pain and back pain. B-boswellic acid, its 11-keto derivative and their acetates are the important constituents derived from the resin which are responsible for the anti-inflammatory activity of Shallaki. Shallaki improves the blood supply to the joints and restores the integrity of blood vessels destroyed by spasms. Degradation of glycosaminoglycans, which leads to articular damage and cartilage breakdown, is a common condition in patients on nonsteroidal anti-inflammatory drugs (NSAIDs). Shallaki significantly reduces the degradation of glycosaminoglycans and protects the joints. So, in this present study an attempt was made to study the anti-arthritic efficacy of the Shallaki in patients by observational study. A total 65 patients who suffered with severe rheumatic pain with joint dysfunction and clinical decline during the treatment with Shallaki capsule was examined. Rheumatoid factor (RF) and Erythrocyte sedimentation rate (ESR) were measured to evaluate the anti arthritic activity. Results of the present study revealed that the percent reduction of ESR found with Shallaki capsule is more than the combination of steroids and NSAIDs. The significant effects were observed with percent reduction of RF by Shallaki capsule then steroids and NSAIDs. The triple combination posses quite more effects than observed with individuals. From the above data it was concluded that the Shallaki capsule posses the ulcer protective anti inflammatory and anti arthritic effects in patients of arthritis, whereby, it is not possible to propose a same effects by conventional steroids and NSAIDs. Shallaki capsule reduces glycosaminoglycan degradation and increases maintenance of collagen which inhibits the progress of arthritis in lower doses.