Gold therapy in rheumatoid arthritis

Area of Science:

• Rheumatology
• Immunogenetics
• Pharmacology

Background:

• Rheumatoid arthritis (RA) is a chronic autoimmune disease causing joint inflammation and damage.
• Gold sodium aurothiomalate (Myocrisin) is a disease-modifying antirheumatic drug (DMARD) used in RA treatment.
• Understanding treatment efficacy and adverse reactions is crucial for managing RA.

Purpose of the Study:

• To evaluate the efficacy and safety of gold sodium aurothiomalate (Myocrisin) in rheumatoid arthritis patients.
• To identify potential risk factors, including HLA antigen associations, for adverse reactions to chrysotherapy.

Main Methods:

• A retrospective study of 114 RA patients treated with gold sodium aurothiomalate between 1971-1979.
• Data analysis of 104 completed treatment protocols, assessing patient benefit, remission, and adverse events.
• HLA tissue typing performed on 37 patients experiencing side effects.

Main Results:

• 67.3% of patients (70/104) showed clinical benefit from chrysotherapy, with 40 achieving complete remission.
• Treatment discontinuation due to side effects occurred in 31.8% of patients (33/104).
• Common adverse reactions included skin rashes (39%), renal complications (14%), and hematological complications (6%), with 2 deaths.

Conclusions:

• Gold sodium aurothiomalate is an effective treatment for a majority of rheumatoid arthritis patients.
• Adverse reactions are common but manageable, necessitating careful patient monitoring.
• A significant association was found between HLA DRw4 antigen and side effects in both White and Coloured patient groups.