Current trends in theranostics for rheumatoid arthritis

The very complexity of Rheumatoid Arthritis (RA) makes its prognosis and management challenging. The manifestations pertaining to RA emerge in the late stage of the disease when the damage to bone and cartilage has already occurred. Therefore early diagnosis of RA becomes critical in order to avoid further complications and disabilities. In such a scenario, theranostics can be an ideal solution to tackle the barriers to disease management in RA patients. Nanotechnology has paved the way for emerging theranostics to achieve better targetability and high performance. The shortcomings of current diagnostic techniques and pharmacological treatment are addressed in this review. The article also summarizes the laboratory studies that have reported promising theranostic entities for RA diagnosis, treatment and discusses the outcomes of each. Novel platforms combined with newer techniques have found application in the theranostics of RA. These platforms include gold nanorods, nanoshells, nanowhiskers, magnetic nanoparticles, solid and mesoporous silica nanoparticles, etc. Photodynamic, chemo-photo responsive, magnetic field based imaging and simultaneous stimulation have been reported for the release of therapeutic moieties from these nanoplatform. Theranostics can also assist clinicians in determining the respondents and non-respondents to biological response modifiers and other treatments available for RA. This not only plays an important role in selecting the suitable therapy for every patient but also in monitoring the progress of treatment in the patient. The advantages of theranostics over current diagnosis and treatment for RA are tremendous. Hence it holds great opportunities for progress and enhancement of RA disease management.