Gold salts for rheumatoid arthritis

Examples

Oral (by mouth)

Generic Name Brand Name
gold/auranofin Ridaura

Intramuscular (by a shot or injection)

Generic Name Brand Name
gold aurothioglucose Solganal
gold sodium thiomalate Aurolate, Myochrysine

How It Works

It is not understood exactly how gold works to treat rheumatoid arthritis. But gold salts appear to accumulate slowly in the body and, over time, they reduce inflammation and slow the progression of rheumatoid arthritis.

Gold injections are given every week for the first 22 weeks. After that, gold may be given less often if it is working.1

Why It Is Used

Gold is used to reduce inflammation and slow disease progression in people with rheumatoid arthritis. Gold is not usually the first treatment given to people with rheumatoid arthritis, since methotrexate and other disease-modifying antirheumatic drugs (DMARDs) are available.

How Well It Works

A review reports that treatment with intramuscular gold (parenteral gold) reduces disease activity and joint inflammation.2

Gold salts taken by mouth (oral) have not been found to be as effective as gold injections, and it can take up to 6 months before benefits are noticed from oral gold salts.1

Side Effects

Side effects may develop after a significant amount of gold has accumulated in the body.

Oral gold has fewer side effects than gold injected into the muscle. Common side effects of oral gold include:

  • Decreased appetite, nausea, and diarrhea.
  • Problems with the skin, blood, kidneys, or lungs (rare).

Common side effects of injected gold include:

  • An itchy skin rash.
  • Mouth sores.

Rarer side effects include:

  • Kidney problems (kidney damage that causes loss of protein in the urine).
  • Suppression of blood cell production, which may increase the risk of infection or serious bleeding. (A return to normal blood cell production may take several weeks after the drug is no longer taken.)

Extremely rare side effects include bowel or lung inflammation.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

What To Think About

It can take 3 to 6 months before gold treatment improves symptoms.

Regular urine tests to check for protein (indicating kidney damage) and blood tests are needed.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

References

Citations

  1. Kwoh CK, et al. (2002). Guidelines for the management of rheumatoid arthritis. Arthritis and Rheumatism, 46(2): 328–346.
  2. Walker-Bone K, Fallow S (2007). Rheumatoid arthritis, search date June 2005. Online version of BMJ Clinical Evidence. Also available online: http://www.clinicalevidence.com.

Last Updated: August 18, 2008

Author: Shannon Erstad, MBA/MPH

Medical Review: Anne C. Poinier, MD - Internal Medicine & Stanford M. Shoor, MD - Rheumatology

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