Gold and antimalarial compounds

There are two classes of drugs, gold compounds and antimalarials which, whilst they have been shown to possess certain experimental anti-inflammatory activities, seem, on the basis of their clinical effects, to have a delayed action against rheumatoid arthritis. Their effect appears to be more selective than that of the salicylates and other drugs previously discussed. Indeed, in view of their favourable influence on the sheep-cell agglutination titre (SCAT), they may even modify the disease process itself. Control of the disease, however, is usually incomplete and their ultimate effect is doubtful . 

Gold compounds also reduced an infective arthritis in mice and rats 5, and an arthritis in rats produced by an exudate from Murphy rat lymphosarcoma . Some of these effects may be the result of a direct action on infecting organisms . Nevertheless, Newbould demonstrated that sodium aurothiomalate possesses moderate anti-inflammatory effects in adjuvant arthritis, a non-infective arthritis, though this was only achieved with the high intramuscular dose of 25 mg/kg/day . 

Sodium aurothiomalate in a dose of 4 mg weekly reduces permeability of the rabbit synovial membrane . The same compound, given intramuscularly in a daily dose equivalent to 0-75 mg of elemental gold, reduced the cotton-pellet granuloma in rats, an effect thought to be due to an increased turnover of adrenocorticosteroids . 

Sodium aurothiomalate, in an intramuscular dose of 25 mg/kg, reduces the leucocytic infiltration but not the exudate formation produced by the implantation of plastic sponge in rats . Lawrence used sodium aurothiomalate containing Au in patients with rheumatoid arthritis, and noted that painful joints gave counts 2-5 times higher than symptomless ones and that 

In 1951, Page reported that mepacrine (quinacrine) was of value in lupus erythematosus and that, in one patient with a polyarthritis of rheumatoid type, there was a simultaneous improvement of skin lesions and arthritis. 

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