Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Numerous open and placebo-controlled trials have shown Auranofin, an oral gold salt, to be effective in the base-line treatment of rheumatoid arthritis. In comparative trials the drug was found to be somewhat less potent than sodium aurothiomalate. Whether it is equal or superior to other base-line antirheumatoids like D-penicillamine or antimalarials, can as yet not be established because of the small patient groups involved in the published trials. While adequately effective clinically, oral gold salts, like their parenteral counterparts, do not halt the radiological progression of rheumatoid lesions. Overall, Auranofin is much better tolerated than the parenteral gold salts, although soft feces are more commonly seen and diarrhea may occur occasionally. Skin rashes as well as proteinuria and thrombocytopenia have been reported in some instances so that, as during parenteral treatment, laboratory studies at regular intervals are mandatory. On account of its oral dosage form and its low side-effect rate Auranofin is a true alternative to conventional parenteral gold salt therapy.
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PMID:[Comparison of oral and parenteral gold therapy--review of the literature]. 644 57

Parenterally administered gold compounds have been used for decades for treatment of rheumatoid arthritis. The new gold compound triethylphosphine gold (auranofin) can be partially absorbed in the gut following oral administration due to its higher lipophilic nature. This is probably also the main cause for the differences in kinetic properties versus the parenteral gold compounds. Following administration of auranofin, there are lower concentrations of gold in blood and organs; 95% of the gold is excreted in feces whereas 70% of gold, following gold sodium thiomalate, is excreted in the urine. These differences have consequences for the mode of adverse reactions. A common property of all gold compounds, however, is the relative distribution in organs. The highest concentrations of gold were found in the reticuloendothelial system, in liver, kidney and spleen, followed by joints. The mode of action of gold compounds is still unexplained. They inhibit some types of experimental inflammation and the activity of various cells involved in inflammatory processes. In some cases auranofin exerts a higher influence. Following incorporation of gold in lysosomes, the impairment of macrophage function appears to be most important. This effect probably influences (indirectly) the immune system since macrophages interact with T- and B-lymphocytes. The significance of these findings for the therapeutic effect of gold compounds is, however, not known. The rate of undesirable effects of gold compounds is very high requiring exact supervision during chrysotherapy. Mucosal and cutaneous reactions are very frequent, followed by proteinuria, diarrhea and thrombocytopenia. Bone marrow aplasia is most serious but relatively rare.(ABSTRACT TRUNCATED AT 250 WORDS)
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PMID:[The pharmacology of gold compounds]. 644 62

Auranofin, an orally active gold preparation, was compared with sodium aurothiomalate in a double-blind trial in patients with rheumatoid arthritis fulfilling the ARA criteria, who had been stabilized on sodium aurothiomalate for at least six months. Twenty-four patients have so far been entered in the trial, of whom fourteen have been randomly allocated to receive auranofin and ten to receive sodium aurothiomalate. After initial stabilization, patients receive either auranofin 6 mg daily and placebo injection, or sodium aurothiomalate 50 mg monthly and placebo tablets. Five patients have completed one year on auranofin. The remaining nine patients were withdrawn because of loss of efficacy (two), side-effects, (five), loss of efficacy and side-effects (one) and default (one). Four patients have completed one year's treatment with sodium aurothiomalate. Of the remaining six patients, two were withdrawn because of side-effects, three because of poor disease control and one because of side-effects and poor disease control. Diarrhoea occurred in eight patients receiving auranofin. Rashes occurred in both groups but otherwise there were no serious side-effects. The efficacy of both drugs appeared similar, there being no significant differences in morning stiffness, fatiguability, visual analogue pain score, grip strength and articular index. There were also no significant differences in laboratory parameters of efficacy. Auranofin appears to control disease activity in rheumatoid arthritis but diarrhoea is a frequent side-effect.
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PMID:A double-blind study comparing sodium aurothiomalate and auranofin in patients with rheumatoid arthritis previously stabilized on sodium aurothiomalate. 644 11

A case of Hodgkin's disease with amyloidosis in various organs in a 68-year-old Japanese man is reported. The initial sign was dysuria followed by diarrhea, melena, and ileus. There was no history of pulmonary tuberculosis or rheumatoid arthritis. Autopsy findings suggested that Hodgkin's disease may have been the initial disease in development of secondary systemic amyloidosis, followed by dysuria and paralytic ileus.
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PMID:Secondary systemic amyloidosis with Hodgkin's disease. 665 Jan 68

One hundred and twelve patients with classical or definite rheumatoid arthritis (RA) were randomly assigned to receive either sodium aurothiomalate (GSTM) or auranofin (AF). Monthly clinical assessments (morning stiffness, grip strength, articular index, pain, quality of life) and concurrent hematological, biochemical, and urine studies were performed to monitor the efficacy/toxicity (E/T) ratio. Ninety-two patients have completed 3 months; 65, 6 months; 47, 9 months; and 30, 12 months. The groups were numerically balanced at each time period. Analysis of the 0-6 month period suggests that both drugs were equally and significantly beneficial after 3 months and that this was maintained at 6 months. Toxicity was as frequent in both groups but more serious in the GSTM group. The main side effects were gastrointestinal (diarrhea) in the AF group and mucocutaneous in the GSTM group. Half of the withdrawals (14 in each group) were because of side effects in the GSTM group and for inadequate therapeutic efficacy in the AF group. This study suggests that after 6 months of treatment the E/T ratio of AF is greater than or equal to that of GSTM. These conclusions will need to be confirmed during the ongoing longer observation period. A significant clinical difference between the 2 drugs is that in a given patient treated with GSTM, the onset of toxicity coincides with a good therapeutic effect. This relationship does not appear to exist during AF treatment.
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PMID:Gold therapy in rheumatoid arthritis. Interim report of the Canadian multicenter prospective trial comparing sodium aurothiomalate and auranofin. 681 82

Auranofin, an orally effective gold compound, was administered to 2 groups of rheumatoid arthritis patients at 2 mg and 6 mg daily respectively in a controlled study. Both groups showed significant improvement in most efficacy measurements by 6 months. More improvement measurements were observed in the 6 mg group at 3 months than the 2 mg group. Dropout rate because of diarrhea was similar in the 2 groups. Other adverse reactions severe enough to force withdrawal of the test drug were infrequent.
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PMID:Auranofin treatment for adult rheumatoid arthritis. Comparison of 2 mg and 6 mg daily dose. 681 77

Auranofin (AF), a new gold compound, has been suggested as an alternative to parenteral gold in the treatment of rheumatoid arthritis (RA). This hypothesis has been tested within a double-blind comparative study and to date 103 patients have been enrolled. Forty-one RA patients have been treated for longer than 6 months. The patients were randomly allocated to treatment with either AF or sodium aurothiomalate (GSTM) and serial comparison of changes within the articular index, grip strength, pain, morning stiffness, and global assessment during treatment were measured. Improvement was noted within both treatment groups. Diarrhea as a side effect was most commonly seen during treatment with AF while rash often combined with pruritus was most commonly reported with GSTM; withdrawal from treatment as the result of this was nevertheless uncommon.
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PMID:Auranofin and sodium aurothiomalate in the treatment of rheumatoid arthritis. A double-blind, comparative multicenter study. 681 83

One hundred and fifty patients with rheumatoid arthritis received 6 mg of auranofin daily for 2-24 months. Thirty patients were withdrawn from the study, and 82 patients were observed for 12 months. Statistical evaluation was available for 74 patients at weeks 24, 38, and 48, respectively. The major side effects observed were diarrhea, rash, and alopecia. Significant improvement was noted in the articular index, ESR, pain, and morning stiffness.
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PMID:Oral gold therapy with auranofin (SK&F 39162). A multicenter open study in patients with rheumatoid arthritis. 681 78

The use of gold therapy in rheumatoid arthritis is not without risk. Although the better known side effects are bone marrow suppression and renal involvement, gold induced enterocolitis has been described. This paper reports a 59-year-old female recently treated with gold therapy for rheumatoid arthritis who developed bloody diarrhoea, toxic dilatation and perforation of her colon. The absence of features of inflammatory bowel disease or infection indicates gold as a possible causative agent. Pathogenesis, therapy and a review of the literature of gold induced enterocolitis are described.
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PMID:Gold induced enterocolitis: case report and a review of the literature. 681 47

Yersinia enterocolitica biotype I were isolated from faeces of 16% of 56 consecutive patients with diarrhoea or gastrointestinal symptoms and 2.8% of 109 healthy controls (p less than 0.01). Similar Yersinia biotypes were isolated from 4% of samples from 86 rheumatoid arthritis patients and 4.5% of samples from 140 ankylosing spondylitis patients examined regularly over an 8-month period. These results suggest that Yersinia enterocolitica biotype I are regular but infrequent inhabitants of the human gastrointestinal tract in south-east England. The increased isolation rate of these microorganisms from patients with enteric disease and from patients with exacerbations of HLA B27-related arthritic and ocular inflammatory disease justifies further investigations.
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PMID:Yersinia enterocolitica biotype I. Diarrhoea and episodes of HLA B27 related ocular and rheumatic inflammatory disease in South-East England. 698 42


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