Gold Treatment in Rheumatoid Arthritis

Fraser, Thomas N.

doi:10.1136/ard.4.4.71

Cited by 116 publications

(23 citation statements)

References 3 publications

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“…Similar but less significant results were obtained by Fraser et al in 1945 andby Waine et al in 1947. But these authors used considerably lower gold dosages than Ellman did.…”

supporting

confidence: 91%

A multicentre1) controlled trial of the effects of different dosage of gold therapy, followed by a maintenance dosage

Cats¹

1976

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In a combined clinical trial with gold in patients with rheumatoid arthritis (RA) 95 patients were treated with a high initial dosage of 2,500 mg aurothioglucose in 21 weeks. Afterwards 48 of these patients received a maintenance dosage of gold and 47 patients placebo injections. Another group of 101 patients received 1,000 mg gold in 21 weeks. Finally a maintenance dose of gold was administered to 49 of these patients, to the other 52 patients placebo injections were administered. For the treatment of RA a high dosage of a gold compound offers no advantage over a low dosage. After a high dosage one can expect a significantly higher number of side effects. The development of toxicity does not influence the ultimate results. A second course of gold has hardly any benificial effect. Prolonged administration of gold is usually well-tolerated; whether it has substantial and sustained therapeutic value remains dubious. Progression of radiological abnormalities can be observed at the same moment that signs and other symptoms of the disease show improvement.

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“…Similar but less significant results were obtained by Fraser et al in 1945 andby Waine et al in 1947. But these authors used considerably lower gold dosages than Ellman did.…”

supporting

confidence: 91%

A multicentre1) controlled trial of the effects of different dosage of gold therapy, followed by a maintenance dosage

Cats¹

1976

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“…World War II disrupted these studies. However the late Dr. Thomas N. Fraser of Glasgow completed his section of the multi-centre trial at the Western Infirmary of Glasgow and published his results in 1945 (Fraser, 1945). Fraser's trial, the first published double-blind controlled trial of any anti-rheumatic drug, confirmed Forestier's original findings and demonstrated an efficacy rate of 82 % in the treated group compared to 45 % in the control patients.…”

Section: Injectable Gold Compoundsmentioning

confidence: 95%

“…Thus, the pa- Vol. 16, 2008 Clinical pharmacology of gold 121 tient compelled to attend a clinic for the injection was more likely to have regular "hands-on" management of their treatment and would perhaps also benefit from the placebo effect that was recorded by Dr. Thomas Fraser (Fraser, 1945). Clinical studies have documented a greater occurrence of adverse reactions for injectable gold compounds compared with those from Auranofin (Ward et al, 1983;Rau et al, 1983;Van Riel et al, 1983a, b) but the severity and relevance of these side effects has to be considered.…”

Section: When Did the Use Of Gold Therapy Begin To Decrease?mentioning

confidence: 97%

Clinical pharmacology of gold

2008

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Since the dawn of civilization, elemental gold and gold compounds have been revered and utilized by Shamen and medical practitioners alike for many varied pathological problems. In the 20(th) century following the observations of Jacques Forestier, injectable gold compounds were successfully used for the treatment of rheumatoid arthritis. Of the many compounds developed, gold sodium thiomalate has been the most extensively studied by basic scientists and by clinicians. In the1980s, the oral gold compound auranofin showed promise as a therapeutic contender to injectable gold, but the clinical side effect profile and fear of long term effects of immune suppression by auranofin, resulted in gold sodium thiomalate continuing as the preferred gold compound for rheumatoid treatment. However, the increased use and demonstration of effectiveness of low dose Methotrexate (MTX) in rheumatoid treatment over the last 20 years has resulted in a significant decline in the use of injectable gold sodium thiomalate, this despite the claims and evidence that it remains a useful agent in the management of rheumatoid arthritis. Several authors still contend that the injectable gold compounds can still play a valuable role, and indeed may be the correct first choice in the management of rheumatoid arthritis.

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“…Although many trials were published afterwards, few had adequate control series, making it difficult to draw useful conclusions. In controlled studies using double blind methods, a significant decrease in pain and inflammatory signs was demonstrated in patients treated with gold salts and it was suggested that this therapy could alter the course of the disease (2)(3)(4)(5). Since then gold salts have been accepted as a part of th, standard medical treatment of rheumatoit arthritis (6).…”

Section: Introductionmentioning

confidence: 99%

Gold- induced aplastic anemia

et al. 1987

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Three patients receiving gold salt treatment for rheumatoid arthritis developed severe aplastic anemia. All three patients experienced remission of their disease at the time of the occurrence of marrow aplasia. Reviewing data on these patients and recent literature indicate that fatal marrow aplasia seems to occur more frequently in sero-negative women who respond well to therapy with gold salts. Frequent blood monitoring in search for any pronounced or sustained drop in red, white or platelet count, even within normal range could serve as a warning sign for myelotoxicity. Despite intensive supportive measures and specific therapeutic attempts, all three patients eventually died of septic shock.

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Gold Treatment in Rheumatoid Arthritis

Cited by 116 publications

References 3 publications

A multicentre1) controlled trial of the effects of different dosage of gold therapy, followed by a maintenance dosage

A multicentre1) controlled trial of the effects of different dosage of gold therapy, followed by a maintenance dosage

Clinical pharmacology of gold

Gold- induced aplastic anemia

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