Abstract
To enhance anthralin efficacy against psoriasis and reduce its notorious side effects, it was loaded into various liposomal and ethosomal preparations. The nanocarriers were characterized for drug encapsulation efficiency, size, morphology and compatibility between various components. Optimum formulations were dispersed in various gel bases and drug release kinetics were studied. Clinical efficacy and safety of liposomal and ethosomal Pluronic®F-127 gels were evaluated in patients having psoriasis (clinicaltrials.gov identifier is NCT03348462). Safety was assessed by recording various adverse events. Drug encapsulation efficiency ≥97.2% and ≥77% were obtained for liposomes and ethosomes, respectively. Particle sizes of 116 to 199 nm and 146 to 381 nm were observed for liposomes and ethosomes, respectively. Fourier-Transform infrared (FT-IR) spectroscopy and differential scanning calorimetry (DSC) studies confirmed the absence of interaction between anthralin and various nanocarrier components. Tested gel bases showed excellent ability to sustain drug release. At baseline, the patients had a median Psoriasis Area and Severity Index (PASI) of 3.4 for liposomes and 3.6 for ethosomes without significant difference. After treatment, mean PASI change was −68.66% and −81.84% for liposomes and ethosomes, respectively with a significant difference in favor of ethosomes. No adverse effects were detected in both groups. Anthralin ethosomes could be considered as a potential treatment of psoriasis.
Highlights
Psoriasis is a chronic non-infectious autoimmune disease of the skin, joints or both characterized by relapsing episodes of inflammatory lesions and hyperkeratotic plaques [1,2,3]
We showed that ethosomes had ~6-fold higher voriconazole permeation through rat abdominal skin compared with the drug hydroalcoholic solution [29]
These results suggest that ethosomes could be a potentially effective delivery system to increase anthralin efficacy against psoriasis and limit its adverse effects
Summary
Psoriasis is a chronic non-infectious autoimmune disease of the skin, joints or both characterized by relapsing episodes of inflammatory lesions and hyperkeratotic plaques [1,2,3]. It is the most prevalent autoimmune disease with a worldwide prevalence of 2–5% [4]. The most characteristic features of psoriasis include circumscribed, red, thickened plaques with an overlying silver-white scale [8]. This scale makes the disease highly visible and negatively impacts the patient’s lifestyle [7]. The visible nature of the disease leads to both physical and psychosocial effects on the patient including social disgrace, state of agony, distress and physical disability [2]
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