Dequeker J, Verdickt W, Gevers G, Vanschoubroek K
Clin Rheumatol. 1984 Mar;3 Suppl 1:67-74. doi: 10.1007/BF03342624.
Oral gold (auranofin) has been used in 31 patients, 20 with active rheumatoid arthritis and 11 with active psoriatic arthritis. In rheumatoid arthritis the oral gold treatment was compared to parenteral gold treatment in a patient blind trial for two years. The psoriatic arthritis cases were incorporated in an open trial. Auranofin 6 mg once daily reduced significantly the activity in rheumatoid arthritis and in psoriatic arthritis. The beneficial effect obtained with auranofin at a dose of 6 mg/day during the first year of treatment could not be maintained by 3 mg/day in the second year. Auranofin compared to parenteral gold had a distinct advantage of better systemic tolerability, although parenteral gold was found to be more potent. There was no greater risk for toxic skin reaction to oral gold in psoriatic arthritis than in rheumatoid arthritis. The overall conclusion of this longterm study is that oral gold (auranofin) 6 mg once daily, although slightly less effective than parenteral gold, can be considered to be the first choice of gold treatment for rheumatoid arthritis and psoriatic arthritis, because the compliance, which is a reflection of a combination of tolerance and efficacy, for oral gold therapy was, in our hands, undoubtedly superior to parenteral gold.
口服金制剂（金诺芬）已应用于31例患者，其中20例为活动性类风湿关节炎患者，11例为活动性银屑病关节炎患者。在类风湿关节炎患者中，口服金制剂治疗与胃肠外金制剂治疗在一项为期两年的患者盲法试验中进行了比较。银屑病关节炎病例纳入了一项开放性试验。金诺芬每日一次，每次6毫克，可显著降低类风湿关节炎和银屑病关节炎的活动度。在治疗的第一年，金诺芬6毫克/天的剂量所获得的有益效果在第二年无法通过3毫克/天的剂量维持。与胃肠外金制剂相比，金诺芬具有全身耐受性更好的明显优势，尽管发现胃肠外金制剂效力更强。银屑病关节炎患者对口服金制剂发生毒性皮肤反应的风险并不高于类风湿关节炎患者。这项长期研究的总体结论是，口服金制剂（金诺芬）每日一次，每次6毫克，尽管疗效略低于胃肠外金制剂，但可被视为类风湿关节炎和银屑病关节炎金制剂治疗的首选，因为在我们看来，口服金制剂治疗的依从性（反映耐受性和疗效的综合情况）无疑优于胃肠外金制剂。
