Gold for rheumatoid arthritis: current perspectives

Gold therapy induces remission in many patients with rheumatoid arthritis (RA). This fact, coupled with improved understanding of gold's mechanism of action and better ability to monitor its side effects, has led to a resurgence of popularity of this drug in the treatment of RA. Gold should be used as an adjunct when basic therapy, ie, aspirin or nonsteroidal antiinflammatory drugs, rest, and physical therapy, fails. Careful patient selection and education; early attention to side effects, especially mouth and skin reactions; and willingness to increase the dosage if the usual regimen does not bring about a satisfactory response, all contribute to successful use of gold. Although only injectable forms of gold are now available in the United States, an oral form that seems to be less toxic is being tested.