Auranofin: a unique oral chrysotherapeutic agent

Area of Science:

• Rheumatology
• Pharmacology
• Immunology

Background:

• Auranofin is an orally administered gold coordination complex.
• It possesses distinct pharmacokinetic and immunologic properties compared to injectable gold compounds.
• Auranofin has demonstrated antiarthritic properties.

Purpose of the Study:

• To evaluate the therapeutic benefits of auranofin in rheumatoid arthritis (RA).
• To compare the efficacy and side effect profile of auranofin with parenteral gold salts.
• To assess the impact of auranofin when added to existing RA treatment regimens.

Main Methods:

• Clinical studies involving oral administration of auranofin (6 mg/day).
• Combination therapy with salicylates and/or nonsteroidal anti-inflammatory drugs.
• Monitoring of clinical and laboratory parameters of disease activity.
• Analysis of patient-reported side effects and withdrawal rates.

Main Results:

• Auranofin provides significant additional therapeutic benefit in RA patients on combined therapy.
• Efficacy approaches that of parenteral gold salts.
• Clinical and laboratory improvements observed by the third month, with further benefits over the first year.
• Most common side effects include gastrointestinal (diarrhea) and mucocutaneous reactions, generally mild.
• Withdrawal rate due to adverse reactions averaged 11%.

Conclusions:

• Auranofin is an effective oral treatment for rheumatoid arthritis, offering benefits comparable to injectable gold.
• It demonstrates a favorable efficacy and safety profile, particularly when used in combination therapy.
• Auranofin presents a different side effect profile than injectable gold, with more gastrointestinal and fewer mucocutaneous reactions, leading to lower withdrawal rates.