Auranofin therapy in rheumatoid arthritis.

Gold is well established as an agent to suppress progressive rheumatoid arthritis. Until recently, gold could only be given parenterally. An orally absorbable gold compound, auranofin, has been undergoing clinical trials in the last 6 years. Auranofin has some effects on the immunologic system, demonstrated in vitro, that differ from its parenteral counterpart, GST. Auranofin appears to have clinical effectiveness in rheumatoid arthritis that approximates that of parenteral gold. Although gastrointestinal toxicity is more frequent with auranofin, renal toxicity is distinctly less frequent than with parenteral gold. There is preliminary evidence that auranofin may have a disease-altering capability, as measured by serial radiographs, similar to that of parenteral gold.