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Use of gold compounds in rheumatic diseases

Author
Alice Klinkhoff, MD
Section Editor
Ravinder N Maini, BA, MB BChir, FRCP, FMedSci, FRS
Deputy Editor
Paul L Romain, MD

INTRODUCTION

Gold compounds have been employed for the treatment of rheumatoid arthritis (RA) since Forestier pioneered their use for this purpose in 1929 [1]. Subsequent randomized trials confirmed the effectiveness of gold in RA (see 'Efficacy of parenteral gold in RA' below). Gold has also been used in psoriatic arthritis and juvenile idiopathic arthritis. However, since the 1980s the use of gold has declined due to multiple advantages of other medications, particularly methotrexate (MTX), when compared with gold; the benefits of these newer medications include convenience, safety, efficacy, and cost.

The pharmacokinetics and use of gold in the treatment of RA are reviewed here. The toxicities of gold therapy, the initial treatment of RA with disease-modifying antirheumatic drugs (DMARDs), and the treatment of RA resistant to initial DMARD therapy are discussed in detail separately. (See "Major side effects of gold therapy" and "Initial treatment of rheumatoid arthritis in adults" and "Treatment of rheumatoid arthritis in adults resistant to initial biologic DMARD therapy", section on 'Resistant to standard therapies' and "Treatment of rheumatoid arthritis in adults resistant to initial nonbiologic DMARD therapy".)

PHARMACOLOGY

Therapeutic gold compounds — Two therapeutic products containing gold are available:

Gold sodium thiomalate (GST), which contains almost 50 percent gold in a water-based solution and is administered by intramuscular (IM) injection every one to four weeks.

Auranofin, which is a gold triethylphosphine compound taken orally each day.

                       

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Literature review current through: Nov 2016. | This topic last updated: Thu Sep 15 00:00:00 GMT 2016.
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