Gene/Protein Disease Symptom Drug Enzyme Compound
Pivot Concepts:   Target Concepts:
Query: UMLS:C0033774 (pruritus)
 14,546 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

The chemistry, pharmacology, pharmacokinetics, clinical use and efficacy, adverse effects, and dosage of auranofin, an oral chrysotherapeutic agent used in treatment of rheumatoid arthritis, are reviewed. Auranofin is lipid-soluble and is monomeric in solution. It has a modulatory effect on both the humoral and cellular immune systems. Auranofin may be a condition-dependent immunoregulating agent rather than an immunosuppressive agent. It inhibits (1) monocyte-mediated antibody-dependent cellular toxicity, (2) release of enzymes from polymorphonuclear leukocytes that may contribute to the pathogenesis of rheumatoid arthritis, and (3) neutrophil activity. In patients with rheumatoid arthritis, 15-33% of an oral dose of auranofin 6 mg is absorbed. Peak plasma gold concentrations are achieved in one to two hours. Gold is highly protein bound. Elimination occurs through the feces and urine; 73-100% of auranofin gold is excreted. Plasma half-life is three weeks. Patients receiving auranofin 3 mg twice daily for rheumatoid arthritis reported improvement after five weeks of therapy; improvement has also been reported with lower doses. Diarrhea, rashes, and pruritus were the most common adverse effects. Auranofin is safe and effective for short- and long-term treatment of patients with rheumatoid arthritis. Its relative safety and potency compared with injectable gold salts and other drugs need further study.
 ...
PMID:Review of auranofin, an oral chrysotherapeutic agent. 642 43

Auranofin is the first orally active gold compound for the treatment of rheumatoid arthritis. Like other chrysotherapeutic agents, its exact mechanism of action is unknown, but it probably acts via immunological mechanisms and alteration of lysosomal enzyme activity. Although long term clinical experience with auranofin is limited, its efficacy appears to approach that of sodium aurothiomalate. Further comparative studies with aurothioglucose, hydroxychloroquine and D-penicillamine are required before definitive statements can be made regarding the relative efficacy of auranofin and these agents. While patients have demonstrated clinical remission of rheumatoid arthritis in response to auranofin therapy, radiological studies have been inconclusive regarding its effect on the occurrence or progression of erosive lesions. Auranofin is relatively well tolerated in most patients, but diarrhoea, skin rash, and pruritus are sometimes troublesome, and thrombocytopenia and proteinuria are potentially serious side effects which may occur during therapy. Whereas mucocutaneous side effects are more frequent with injectable gold compounds, gastrointestinal reactions are the most common adverse effect seen with auranofin. The frequency of side effects has been similar with auranofin and sodium aurothiomalate, but they are generally less severe with auranofin. While some of the side effects are controlled by a reduction in dosage, temporary or permanent withdrawal of auranofin may be necessary. Auranofin is clearly a useful addition to the limited list of agents with disease-modifying potential presently available for the treatment of rheumatoid arthritis. It will doubtless generate much interest as its final place in therapy becomes better defined through additional well-designed studies and wider clinical experience.
 ...
PMID:Auranofin. A preliminary review of its pharmacological properties and therapeutic use in rheumatoid arthritis. 642 23

Auranofin (Ridaura SK and F 39 162) was tested in an open multicenter study with regard to its anti-inflammatory effect in 166 patients suffering from rheumatoid arthritis. The time for treatment lasted for one or two years. The therapeutic effect of the drug was judged by its influence on pain, joint swelling, morning stiffness, grip strength, blood-sedimentation rate and rheumatoid factor etc. The serum gold concentration was measured regularly. With Auranofin the majority of the patients achieved a lasting improvement of the condition. The therapeutical effect was observed gradually. Side-effects were frequent but removal from the therapy was rare. Most of the side-effects were diarrhea, rash, pruritus and conjunctivitis. Regular laboratory controls revealed in some cases toxic organic reactions.
 ...
PMID:[Auranofin in the treatment of chronic polyarthritis. Results of an open multicenter study]. 644 53

A multicenter double-blind comparative study with auranofin (Ridaura) and Na-auro-thiomalate (Tauredon) was carried out in order to investigate under controlled conditions whether the new oral gold compound may be an alternative to injections of gold salts. 121 patients were included in the study, data of 86 patients treated for at least one year could be analysed. The following parameters were examined at regular intervals: number of painful and swollen joints, grip strength, morning stiffness, pain and general health on the visual analogue scale, ESR; from these data the articular index and activity index (according to Lansbury, with slight modifications) were calculated. Blood samples for routine safety monitoring and serum gold levels as well as urine tests were obtained regularly. Both treatment groups showed similar improvement in the values for efficacy measurements after one year, starting within 8 to 12 weeks. Patients in the auranofin group with a disease duration of less than 2 years showed greater improvement in the values for efficacy assessment with the exception of grip strength and the number of tender joints than patients with a disease duration of 2 years or more. No such trend was seen in the Tauredon-subgroups. Numerous side effects were recorded in both groups: 89.7% of the patients on Tauredon and 68.8% of the patients on auranofin had observed one symptom during the course of one year. There was a clear distinction concerning the nature of side effects: mucocutaneous symptoms, especially rash and pruritus, were approximately twice as common with Tauredon, whereas diarrhoea was much more frequent in patients treated with auranofin.(ABSTRACT TRUNCATED AT 250 WORDS)
 ...
PMID:[Multicenter double-blind comparison of auranofin and Tauredon]. 644 55

Viral hepatitis characterized by prolonged cholestasis has not been associated with a specific serologic marker. We report the cases of six patients presenting with a clinical syndrome typical of cholestatic hepatitis who were subsequently found to have acute hepatitis A. Usual features include pruritus, fever, diarrhea, and weight loss with serum bilirubin levels greater than 10 mg/dL, and a clinical course lasting at least 12 weeks. All patients recovered completely without sequelae. Knowledge of this unusual manifestation of hepatitis A may help avoid potentially invasive procedures involved in the evaluation of suspected obstructive jaundice and facilitate appropriate immunoprophylactic measures.
 ...
PMID:Prolonged intrahepatic cholestasis secondary to acute hepatitis A. 648 95

The prevalence of autonomic disturbances in diabetics was investigated using a direct questionnaire. Compared to non-diabetics and healthy subjects, diabetics had a much higher incidence of paresthesia in the limbs (41%) and impotence (66%). These two symptoms proved to be important in diabetic autonomic neuropathy. Other symptoms of autonomic disturbances in diabetics such as postural vertigo, abnormal sweating, diarrhea and constipation, abnormally cold or burning feet, itching, thirst, urinary bladder disturbance and libido decrease in females seemed to be non-specific for diabetic autonomic neuropathy. Paresthesia in the limbs, abnormally cold or burning feet, urine bladder disturbance and impotence were thought to be related to some degree to the duration, severity and complications of diabetes respectively.
 ...
PMID:Prevalence of autonomic disturbances in diabetics as compared with non-diabetics and healthy subjects. 668 May 21

Fifty-two of 142 (37%) American ex-prisoners of war that worked on the Burma-Thailand Railroad during World War II were found to have previously unrecognized symptomatic Strongyloides stercoralis infections. A characteristic urticarial creeping skin eruption on the abdomen, buttocks and thighs occurred in 92%. Infection was also associated with pruritus ani, abdominal pain, indigestion, heartburn, and diarrhea. Demonstration of larvae in ether-formalin stool concentrates in these chronic low density infections required 5 hours of microscopy per case to detect 90% of positive cases. Therapy with thiabendazole resulted in a clinical cure in 93% and a microscopic cure in 100%; but was associated with frequent side effects. Chronic strongyloidiasis should be considered in veterans of Far East conflicts and in others with intimate soil contact in rural Strongyloides stercoralis-endemic areas who present with recurrent creeping skin eruption, abdominal pain, and eosinophilia.
 ...
PMID:Chronic strongyloidiasis in World War II Far East ex-prisoners of war. 669 84

Mastocytosis gives rise to clinical symptoms such as flushing, itching and diarrhoea. We report a patient with urticaria pigmentosa without evidence of systemic involvement but with recurrent episodes of diarrhoea. The patient had elevated circulating levels of calcitonin, which might have been a mediator of her diarrhoea. We suggest that serum calcitonin level should be checked in patients with mast cell disease and diarrhoea.
 ...
PMID:Hypercalcitoninaemia in a patient with urticaria pigmentosa. A possible cause of diarrhoea. 673 Oct 41

Oral gold(Auranofin; SKF) 6 mg/d has been used in an open study in 31 patients with active rheumatoid disease, 19 of whom have been on continuous treatment for 1 year. Four of these patients were considered to be in remission and 9 had a good clinical response to treatment. Four showed only minimal improvement and 2 did not improve at all. There were, however, no changes in the biochemical parameters of inflammation, e.g. haemoglobin concentration, erythrocyte sedimentation rate, platelet count and rheumatoid factor, or in renal and hepatic function. Of the 31 patients, 9 (29%) have discontinued treatment but only 3 (9.7%) because of side-effects. Minor side-effects have been fairly common, occurring in 19 patients (61%), and included skin rashes and pruritus, diarrhoea and loose stools, nausea, stomatitis and thrombocytopenia or leucopenia. Oral gold would seem to be a safer, less potent form of chrysotherapy than parenteral gold.
 ...
PMID:An oral gold formulation in rheumatoid arthritis. A 12-month follow-up report. 681 Apr 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.
 ...
PMID:Auranofin and sodium aurothiomalate in the treatment of rheumatoid arthritis. A double-blind, comparative multicenter study. 681 83


<< Previous 1 2 3 4 5 6 7 8 9 10 Next >>