Cyclodextrins as Complexation Agents to Improve the Anti-inflammatory Drugs Profile: a Systematic Review and Meta-Analysis

BACKGROUND: Anti-inflammatory drugs can be ineffective in treating some inflammatory conditions. Improved drug delivery systems like cyclodextrins (CDs) could enhance their efficacy and safety. OBJECTIVE: We conducted a systematic review to evaluate the anti-inflammatory activity of compounds complexed in CDs, analyzing whether these complexes improved their pharmacological action. METHODS: The search terms 'Anti-inflammatory Agents', 'Cyclodextrins' and 'Drug effects' were used to retrieve articles in SCOPUS, PUBMED, MEDLINE and EMBASE. RESULTS: Forty-four papers were identified. In the in vivo and clinical studies, there was greater efficacy for complexed drugs when compared to control groups or uncomplexed drug, decreasing inflammation and inflammatory mediators. Through a meta-analysis, the preclinical studies demonstrated that the complexed drug had a significantly (p<0.001) greater anti-inflammatory effect than the non-CD-complexed drug. CONCLUSION: The use of CDs can improve the action of anti-inflammatory compounds and it can also be a way to reduce the side effects, therapeutic doses and toxicity.