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Related Experiment Videos

Injectable gold for rheumatoid arthritis.

P Clark1, P Tugwell, K Bennet

  • 1Health Services Research, Veterans Affairs Medical Center, Mailbox Station 152, 2002 Holcombe Blvd, Houston, Texas 77024, USA. mes@bcm.tmc.edu

The Cochrane Database of Systematic Reviews
|May 5, 2000
PubMed
Summary

Injectable gold offers significant short-term benefits for rheumatoid arthritis patients, improving joint swelling and assessments. However, its use is limited by a higher incidence of toxicity and patient withdrawals.

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Area of Science:

  • Rheumatology
  • Pharmacology
  • Clinical Trials

Background:

  • Rheumatoid arthritis (RA) is a chronic inflammatory disorder.
  • Injectable gold compounds have been used historically for RA treatment.
  • Assessing the balance of efficacy and toxicity is crucial for treatment decisions.

Purpose of the Study:

  • To evaluate the short-term efficacy of injectable gold in rheumatoid arthritis.
  • To quantify the risk of side-effects associated with injectable gold therapy.
  • To provide evidence-based information for clinical practice regarding gold injections for RA.

Main Methods:

  • Systematic review and meta-analysis of randomized clinical trials (RCTs).
  • Searched Cochrane Musculoskeletal Group trials register and Medline up to July 1997.

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  • Included RCTs comparing injectable gold against placebo in RA patients, assessing outcomes at 6 months.

    • Main Results:

    • Four trials with 415 patients were analyzed.
    • Injectable gold demonstrated statistically significant benefits in reducing swollen joints (30% improvement), ESR, and patient/physician global assessments compared to placebo.
    • A higher rate of withdrawal due to toxicity was observed in the gold group (22%) versus controls (4%), with an odds ratio of 3.9.

    Conclusions:

    • Injectable gold provides significant short-term clinical benefits for rheumatoid arthritis patients.
    • The clinical utility of injectable gold is constrained by a notable incidence of serious toxicity.
    • Careful patient selection and monitoring are warranted when considering injectable gold therapy for RA.