Longterm auranofin therapy in patients with juvenile rheumatoid arthritis

Auranofin (AF, Ridaura) was administered to 23 children with juvenile rheumatoid arthritis during a prospective, open labelled, noncontrolled trial designed to establish longterm safety and preliminary efficacy. Dosages of AF were up to 0.2 mg/kg/day, with either aspirin (60-80 mg/kg/day), naproxen (400-600 mg/m2/day), or tolmetin sodium (20-40 mg/kg/day) serving as the concurrent nonsteroidal antiinflammatory drug. Nearly all patients showed an initial favorable response, however tachyphylaxis occurred in one-third (mean duration of therapy prior to the development of inefficacy = 22.6 mo). Clinical remission was observed in 6 patients an average of 15 months after enrollment. The drug appears to be safe for extended periods; 7 children are continuing AF at the present time with a mean duration of therapy of 4.25 years (maximum followup = 4.6 years).