Pandya A G, Dyke C
Department of Dermatology, University of Texas Southwestern Medical Center, Dallas, USA.
Arch Dermatol. 1998 Sep;134(9):1104-7. doi: 10.1001/archderm.134.9.1104.
Although gold has been reported to be useful in treating pemphigus vulgaris, its use has waned in recent years because of concerns regarding efficacy and toxicity.
To review 26 patients with pemphigus who were treated with intramuscular gold over a 10-year period.
Gold was effective in 62% of patients as a primary treatment for pemphigus or as a steroid-sparing agent. An average of 3 months of therapy was required before the daily prednisone dosage could be halved. Four patients were free of disease and stopped receiving all therapy at the conclusion of the study. Toxic effects due to gold therapy developed in 42% of patients and all adverse effects resolved with its cessation.
While toxic effects limit the use of gold in many patients with pemphigus, it may be effective in treating a large percentage of patients who otherwise are unable to reduce their steroid requirement. Because of its delayed onset of action, patients treated with gold usually require systemic steroids when therapy is initiated. Controlled, prospective trials are needed to further evaluate the efficacy of gold and its potential steroid-sparing effects.
尽管有报道称金制剂可用于治疗寻常型天疱疮，但由于对其疗效和毒性的担忧，近年来其使用有所减少。
回顾在10年期间接受肌肉注射金制剂治疗的26例天疱疮患者的情况。
作为天疱疮的主要治疗方法或作为激素减量剂，金制剂在62%的患者中有效。平均需要3个月的治疗才能使每日泼尼松剂量减半。4例患者疾病痊愈，在研究结束时停止接受所有治疗。42%的患者出现了金制剂治疗的毒性反应，停止用药后所有不良反应均消失。
虽然毒性反应限制了金制剂在许多天疱疮患者中的使用，但它可能对很大一部分否则无法减少激素用量的患者有效。由于其起效延迟，开始用金制剂治疗的患者通常在治疗开始时需要全身使用类固醇。需要进行对照的前瞻性试验来进一步评估金制剂的疗效及其潜在的激素减量作用。
