Chrysotherapy: pharmacological and clinical correlates.

Area of Science:

• Rheumatology
• Clinical Pharmacology

Background:

• Chrysotherapy, a treatment for rheumatoid arthritis (RA), involves gold administration.
• Serum gold concentrations can fluctuate widely despite standard dosing.

Purpose of the Study:

• To investigate the relationship between gold administration, serum gold levels, and therapeutic response in RA patients.
• To explore pharmacokinetic principles for optimizing chrysotherapy.

Main Methods:

• Observational study of 56 RA subjects over five years of weekly chrysotherapy.
• Monitoring of serum gold content and clinical/laboratory responses.
• Individual dosage adjustments based on patient serum gold levels.

Main Results:

• Significant fluctuations in serum gold levels were observed.
• Higher sustained serum gold concentrations (greater than 300 mug per cent) correlated with prolonged enhanced clinical and laboratory response.
• Maintaining higher serum levels may improve gold access to deeper body compartments.

Conclusions:

• Pharmacokinetic principles are crucial for optimizing chrysotherapy.
• Achieving and maintaining serum gold levels above 300 mug per cent is important for sustained therapeutic effects in RA.
• Individualized dosing based on serum gold monitoring can enhance treatment efficacy.