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A 1997 review (Suarez-Almazor ME, et al) [6] reports that treatment with intramuscular gold (parenteral gold) reduces disease activity and joint inflammation. Gold-containing drugs taken by mouth are less effective than by injection. Three to six months are often required before gold treatment noticeably improves symptoms.
Sodium aurothiomalate (INN, known in the United States as gold sodium thiomalate) is a gold compound that is used for its immunosuppressive anti-rheumatic effects. [ 2 ] [ 3 ] Along with an orally-administered gold salt, auranofin , it is one of only two gold compounds currently employed in modern medicine.
Auranofin is used to treat rheumatoid arthritis.It improves arthritis symptoms including painful or tender and swollen joints and morning stiffness. [5] Auranofin is a safer treatment compared to the more common injectable gold thiolates (gold sodium thiomalate and gold thioglucose), but meta-analysis of 66 clinical trials concluded that it is somewhat less effective.
Gold thioglucose features gold in the oxidation state of +I, like other gold thiolates. It is a water-soluble, non-ionic species that is assumed to exist as a polymer. [ 1 ] Under physiological conditions, an oxidation-reduction reaction leads to the formation of metallic gold and sulfinic acid derivative of thioglucose.
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Gold: Gold salt complexes have been used to treat rheumatoid arthritis (Figure 3). The gold salts are believed to interact with albumin and eventually be taken up by immune cells, triggering anti-mitochondrial effects and eventually cell apoptosis. This is an indirect treatment of arthritis, mitigating the immune response.
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