Arthritis treatment, auranofin

Gold compounds, including auranofin are used in the treatment of rheumatoid arthritis. 

Furst DE. Mechanism of action, pharmacology, chnical efficacy and side effects of auranofin. An orally administered organic gold compound for the treatment of rheumatoid arthritis. Pharmacotherapy 1983 3(5) 284-98. 

Jessop JD, O Sullivan MM, Lewis PA, Williams LA, Camilleri JP, Plant MJ, Coles EC. A long-term five-year randomized controlled trial of hydroxychloroquine, sodium aurothiomalate, auranofin and penicillamine in the treatment of patients with rheumatoid arthritis. Br J Rheumatol 1998 37(9) 992-1002. 

Finkelstein AE, Walz DT, Batista V, Mizrazi M, Roisman F, Misher A. Auranofin - new oral gold compound for treatment of rheumatoid arthritis. Ann Rheum Dis 1976 35 251-257. 

Berglof FE, Berglof K, Walz DT. Auranofin an oral chrysotherapeutic agent forthe treatment of rheumatoid arthritis. J Rheumatol 1978 5 68-74. 

Davis P, Menard H, Thompson J, Harth M, Beaudet F. One-year comparative study of gold sodium thiomalate and auranofin in the treatment of rheumatoid arthritis. J Rheumatol 1985 12 60-67. 

Ward JR, Williams HJ, Egger MJ, Reading JC, Boyce E, Altz-Smith M, Samuelson CO, Willkens RF, Solsky MA, Hayes SP, Blocka KL, Weinstein A, Meenan RF, Guttadauria M, Kaplan SB, KlippelJ. Comparison of auranofin, gold sodium thiomalate and placebo in the treatment of rheumatoid arthritis A controlled clinical trial. Arthritis Rheum 1983 26 1303-1315. 

Wenger ME, Alexanders, Bland JFI, Blechman WJ. Auranofin versus placebo in the treatment of rheumatoid arthritis. Am J Med 1983 75 123-127. 

Flochberg MC. Auranofin or D-penicillamine in the treatment of rheumatoid arthritis. Ann Intern Med 1986 105 528-535. Revach M, Freed RL, Ehrlich GE. Reversible proteinuria as a complication of oral gold therapy [Letter]. Arthritis Rheum 1979 22 1417-1418. 

Gold drugs, such as aurothioglucose, gold sodium thiomalate, and auranofin, have long been used in the treatment of rheumatoid arthritis. The most common adverse effects associated with gold therapy appeared in skin and mucous membranes (about 15% of all patients) and kidneys (about 5-10%), mostly as proteinuria. 

A gold complex auranofin has been developed for the treatment of rheumatoid arthritis. This is a typical linear two-coordinate complex of gold , with soft S and P donors to match the soft metal ion (Figure 9.4). The bulky ligands here promote compatibility in the bio-environment, and activity is influenced by the substituents on the RS and R3P ligands. Gold complexes have also been examined for antimicrobial, antimalarial and anti HIV (human immunodeficiency virus) activity. A copper(II) complex (Figure 9.4) is effective as a competitive inhibitor of HIV-1. 

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