Gold-containing drugs

Gold salts are primarily used in medicine, to reduce inflammation and to slow disease progression in patients with rheumatoid arthritis, and for some industrial purposes.

Medical uses

Indications

Chrysotherapy or aurotherapy are terms used for treatment with gold compounds. Gold salts accumulate slowly in the body and, over time, reduce inflammation. Gold salts are used to slow the progression of rheumatoid arthritis, inflammatory bowel disease, psoriatic arthritis, membranous nephritis, lupus erythematosus and juvenile rheumatoid arthritis (JRA).

The chemical means by which gold works to treat arthritis are not well understood. At present, gold salts are infrequently used to treat children with JRA, as methotrexate is the convention. Gold salts are sometimes used for children with progressive polyarthritis who are unresponsive to non-steroidal anti-inflammatory drugs, methotrexate, and other medications. Frequent doctor visits, lab tests, and the cost of gold can make this treatment expensive.

Administration

Gold can be administered orally or by intramuscular injection, in which case it is administered weekly for approximately three to five months before less-frequent doses begin. Auranofin, in capsule form for oral administration, is marketed under the brand name Ridaura. Gold sodium thiomalate (brand name Aurolateor or Myochrysine) and gold aurothioglucose (Solganal) are administered by injection. Regular urine tests to check for protein (indicating kidney damage) and blood tests are needed.

Efficacy

A 2005 review (Suarez-Almazor ME et al) reports that treatment with intramuscular gold (parenteral gold) reduces disease activity and joint inflammation. Gold salts taken by mouth (oral) have not been found to be as effective as gold injections, and it can take three to six months before gold treatment noticeably improves symptoms.

A 2002 paper (Richards et al) chronicles the neurological side effects of gold salts reported in the medical literature. "[T}here are reports pointing to a possible involvement of naturally-occurring gold in the nervous and glandular systems, and evidence from historical sources of a possible efficacy of gold in therapy for neurological disorders," according to the study authors. "This research has the potential for re-establishing gold as a significant therapeutic agent in a much wider range of disorders than those for which it is currently used. And it could help in sorting out valid from invalid claims of benefits from supplementation."

Side effects

Side effects may develop after a significant amount of gold has accumulated in the body. Gold compounds, take up to two months to reach a 'steady state', and have a fairly long half life. In 10 days, only 70% is excreted, making gold toxicity problems that might occur relatively difficult to deal with and more difficult to overcome rapidly.[1] The potential benefits for patients with inflammatory bowel disease, skin rash or a history of bone marrow depression should be weighed against the potential risks of gold toxicity on previously compromised organ systems or with decreased reserve. Potential problems with detection and correct attribution of toxic effects must also be considered.

Orally administered gold has fewer side effects than intramuscular injections. Common side effects of oral gold include decreased appetite, nausea, hair thinning and diarrhea, as well as problems affecting skin, blood, kidneys, or lungs. Common side effects of injected gold include an itchy skin rash or mouth sores, with rare instances of kidney problems or suppression of blood cell production.

Potential future uses

Gold salts have recently been linked to the treatment of autism, see autism therapies for more details.

Types of gold salts

Medical use:

• Auranofin
• Aurothioglucose
• Gold sodium thiomalate
• Gold sodium thiosulfate
• Sodium aurothiomalate

Industrial use:

• Potassium gold cyanide (KAuCN2), containing 68.2% by weight of gold, is sometimes used for industrial purposes such as electro-plating; potential risks include occupational contact eczema.

References

• Emery P, Suarez-Almazor M (2002). "Rheumatoid arthritis". Clinical Evidence (10): 1454–1476. PMID 12230730.
• Kwoh CK, et al. (2002). "Guidelines for the management of rheumatoid arthritis". Arthritis and Rheumatism, 46(2): 328–346. PMID 11840435.
• Petiot P, Charles N, Vial C, McGregor B, Aimard G, Trillet M, Bady B. Rev Neurol (Paris), "Neurological complications caused by gold salts. Nosologic report apropos of a case" (article in French). 1993;149(10):562-5. PMID 7912843.
• Richards DG, McMillin DL, Mein EA, Nelson CD. Gold and its relationship to neurological/glandular conditions. Int J Neurosci 2002;112:31-53. MeridianInstitute.com PMID 12152404.
• Suarez-Almazor ME, Bennett KJ, Bombardier C, Clark P, Shea BJ, Tugwell P, Wells G, - 'Injectable gold for rheumatoid arthritis', Cochrane Review (2005) Cochrane.org PMID 10796386

External links

• BCHealthGuide.org - 'Gold salts for juvenile rheumatoid arthritis'
• DiseasesDatabase.com - 'Gold salts information'
• IMVA.info - 'Mineral Therapy and the Use of Gold', Mark Sircus Ac, OMD, International Medical Veritas Association
• MedicineNet.com - 'Aurothioglucose is a gold salt used in treating inflammatory arthritis'
• MonstersAndCritics.com - 'The Age of Autism: Gold salts pass a test: In a Striking Follow-up to Our Reporting on the First Child Diagnosed with Autism --and His Improvement After Treatment with Gold Salts-- a Chemistry Professor Says Lab Tests Show the Compound Can 'reverse the Binding' of Mercury to Molecules.', Dan Olmsted, UPI (2005)
• Neurodiversity.com - 'Unchelated Autistics "Just Lost"???' (December 30, 2005)
• ScienceDaily.com - 'The Age of Autism: Gold salts to be tested', Dan Olmsted, United Press International (UPI) (August 29, 2005)

• UPI.com - 'The Age of Autism: Gold standards', Dan Olmsted, UPI (December 30, 2005)
• Washington.edu - 'About gold treatment: What is it? Gold treatment includes different forms of gold salts used to treat arthritis', University of Washington (December 30, 2004)