Chrysotherapy drugs

The complexes which have been used in chrysotherapy (the treatment of rheumatoid arthritis by gold drugs) are given in Table 9. Of these, (11), (12) and (18) are the most important. Complexes (11) and (12) were for many years dominant, but they must be administered parenterally, and the new drug (18) is unique in that it is therapeutically beneficial when administered orally.9-14 240... 

Chrysotherapy was not readily accepted in the United States As late as 1934, Cecil reported that drugs played a relatively minor role in treatment of rheumatoid arthritis and that his experience with gold compounds had never shown striking results (19) ... 

Gold compounds were originally brought into clinical use accidentally for the treatment of rheumatoid arthritis (l.> However, controlled clinical trials ( ) confirmed their effectiveness, and gold therapy ("chrysotherapy ) is now considered to be as good as that using any other drug for the difficult cases, and one of the few that can lead to repair of joint tissue. 

The consideration here will concern itself with chrysotherapy (gold), D-penicillamine, and the antimalarial drug hydroxychloroquine (Fig. 5-6). 

The antirheumatic action of D-penicillamine initially had limited application. However, in the early 1970s controlled trials have established the drug s intrinsic activity. There are many similarities to chrysotherapy both in clinical response (lowering of rheumatoid factor serum titer, decreased inflammatory response) and adverse effects (glomerulonephritis). However, some are potentially very serious, particularly aplastic anemia and systemic lupus erythematosus (SLE). The most important hint as to the uncertain mechanism of penicillamine s disease-suppressive properties is probably the considerable decrease in IgM (rheumatoid factor) levels. 

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