Kean W F, Kean I R L
Department of Medicine (Rheumatology), McMaster University, Hamilton, L8N 1T8, Ontario, Canada.
Inflammopharmacology. 2008 Jun;16(3):112-25. doi: 10.1007/s10787-007-0021-x.
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.
自文明诞生之初，单质金和金化合物就受到萨满教巫师和医学从业者的尊崇，并被用于治疗多种不同的病理问题。20世纪，在雅克·福雷斯蒂耶的观察之后，可注射金化合物成功用于治疗类风湿性关节炎。在研发出的众多化合物中，硫代苹果酸金钠受到基础科学家和临床医生的研究最为广泛。20世纪80年代，口服金化合物金诺芬有望成为可注射金的治疗替代物，但金诺芬的临床副作用以及对其免疫抑制长期影响的担忧，使得硫代苹果酸金钠仍是类风湿治疗中首选的金化合物。然而，在过去20年里，低剂量甲氨蝶呤（MTX）在类风湿治疗中的使用增加且疗效得到证实，导致可注射硫代苹果酸金钠的使用显著下降，尽管有说法和证据表明它在类风湿关节炎的治疗中仍是一种有用的药物。几位作者仍然认为，可注射金化合物仍能发挥重要作用，实际上可能是类风湿关节炎治疗的正确首选。
