Osteoarthritis is a chronic inflammatory disease characterized by cartilage degeneration. Anti-inflammatory therapy has limited effects, and effective reduction of cartilage wear through lubrication is essential. In vivo stability and lubricity of commercial lubricants are insufficient, leading to failure of lubricating treatment and progression of osteoarthritis. To address these issues, new therapeutic methods combining anti-inflammation and stable highperformance lubrication are developed. Inspired by the sliding mechanism of snowboards, a "nano-snowboard" by modifying molybdenum disulfide (MoS 2 ) with a biomimetic phospholipid polymer poly (dopamine methacrylamide-co-2-methacryloyloxyethyl phosphorylcholine) (PDMPC) and loading anti-inflammatory drug diclofenac sodium (DS), namely MoS 2 -PDMPC-DS, has been synthesized. MoS 2 with a 2D layered structure and photothermal properties, serves as solid lubricant and drug carrier. Meanwhile, the modification of PDMPC on the surface of MOS 2 avoids the oxidative denaturation of MoS 2 in a physiological environment, forming solid-liquid composite lubrication and improving the lubricity and stability of MoS 2 in the joint cavity. In vitro and in vivo experiments show that MoS 2 -PDMPC-DS can stay in the joint cavity for more than one week and exert long-lasting lubrication and anti-inflammatory effects to treat osteoarthritis effectively. This solid-liquid composite lubricating nano-snowboard provides a new idea for synergistic anti-inflammatory and lubricating treatment of osteoarthritis.
(1) Background: Topical non-steroidal anti-inflammatory drugs (NSAIDs) are one of the primary drugs for treating musculoskeletal pain. However, there are currently no evidence-based recommendations about drug selection, drug administration, drug interactions, and use in special populations or other pharmacology-related content of such medications. To this end, the Chinese Pharmaceutical Association Hospital Pharmacy Professional Committee developed multidisciplinary guidelines on using topical NSAIDs to treat musculoskeletal pain. (2) Methods: The guidelines development process followed the World Health Organization guideline development handbook, the GRADE methodology, and the statement of Reporting Items for Practice Guidelines in Healthcare. The guideline panel used the Delphi method to identify six clinical questions to be addressed in the guidelines. An independent systematic review team conducted a systematic search and integration of evidence. (3) Results: Based on the balance between the benefits and harms of an intervention, the quality of the evidence, patient preferences and values, and resource utilization, the guideline panel developed 11 recommendations and nine expert consensuses on using topical NSAIDs to treat acute and chronic musculoskeletal pain. (4) Conclusions: Based on the effectiveness and overall safety of topical NSAIDs, we recommend patients with musculoskeletal pain use topical NSAIDs and suggest high-risk patients use topical NSAIDs, such as those with other diseases or receiving other concurrent treatments. The evidenced-based guidelines on topical NSAIDs for musculoskeletal pain incorporated a pharmacist perspective. The guidelines have the potential to facilitate the rational use of topical NSAIDs. The guideline panel will monitor the relevant evidence and update the recommendations accordingly.
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