Auranofin and gold sodium thiomalate in the treatment of rheumatoid arthritis: A one-year,double-blind,comparative multicenter study

Summary In a 48-week, double-blind trial, 122 patients were randomly assigned to treatment with auranofin (60) and gold sodium thiomalate (GST) (62) at five centers. Both groups showed significant improvement (P<0.05) from baseline in parameters of disease activity. Results of the covariance analysis for all patients who completed the trial showed no significant differences (P<0.05) in efficacy between the two groups. The proportions of patients showing 50% or greater improvement in tender joints, swollen joints, activity index, severity of pain, general health rating, and erythrocyte sedimentation rate (ESR) were similar for both auranofin-treated and GST-treated patients who completed the 48-week trial. When all patients who entered the trial were evaluated, a slightly greater proportion of patients on auranofin had improved. Diarrhea occurred more frequently with auranofin (32%) compared to GST (19%), whereas rash and pruritus were twice as common in those patients treated with GST compared to those treated with auranofin. The withdrawal rate due to adverse reactions was 10% for auranofin vs 26% for GST. It was concluded that the efficacy of auranofin was comparable to that of injectable gold and was better tolerated, as evidenced by the lower withdrawal rate from adverse events for the auranofin patients.Abbreviations ARA American Rheumatism Association - ESR Erythrocyte sedimentation rate - GGT Gamma-glutamyl-transpeptidase - GST Gold sodium thiomalate - NSAID Nonsteroidal antiinflammatory drug - RA Rheumatoid arthritis - SGOT Serum-glutamate-oxalacetate transaminase - SGPT Serum-glutamate-pyruvate transaminase - WBC White blood countDedicated to Prof. Dr. N. Zöllner on the occasion of his 65th birthday