Blaine M. Sutton

Gold compounds for rheumatoid arthritis

Auranofin [2,3,4,6-tetra-0-acetyl-1-thio-β-D-glucopyranosato-S)-(triethylphosphine)gold], a new gold compound for treating rheumatoid arthritis (RA), is unique in that it produces its therapeutic benefit when administered by the oral route. Currently used gold preparations (sodium aurothiomalate, aurothioglucose) must be given by injection to be effective. Auranofin has been used in the treatment of RA patients in clinical trials, and is comparable in efficacy to presently used injectable agents. Side effects with auranofin are mild in nature and result in fewer withdrawals from therapy than do injectable gold preparations.

Chapter 31 Metals in Treatment of Disease

Publisher Summary This chapter reviews the therapeutic use of different metallic compounds. Lithium salts that had been used for the treatment of various diseases, led to their disuse for serious side effects. In recent years, judicious use of lithium salts, primarily lithium carbonate, for the control of manic symptoms has re-established their utility in clinical practice. Recent extensive reviews describe current indications for lithium therapy, primarily in bipolar disorders and experimentally in unipolar depression as well as schizo-affective schizophrenia, alcoholism, premenstrual cramps, and character disorders. Iron deficiency anemia remains frequent in many populations including the affluent countries, where dietary deficiencies are not prevalent. Ferrous sulfate remains the cheapest form of supplemental iron although numerous pharmaceutical forms are available. Although ferric salts are not used therapeutically, ferric ion participates in many biochemical events. Intensive studies of different transition metal complexes in cancer chemotherapy have focused attention on platinum complexes as being of greatest potential. Cis-platinumdiaminodichloride has been approved recently for the treatment of and ovarian cancer, as well as showing promise in other neoplastic conditions. Copper in the metallic state, as well as different salt forms, has been used because of antiquity for the treatment of different inflammatory conditions. A copper complex of salicylic acid has been reported to be of clinical benefit in rheumatoid arthritis (RA) when administered intravenously. Recent publications state that gold preparations inhibit the release of the mediators of immediate hypersensitivity that are concerned with allergic responses. Zinc sulfate supplementation has been used to treat post surgical patients and patients with major burns to facilitate wound healing, recurrent idiopathic oral ulcerations. Zinc salts have been recommended as chemotherapeutic agents for animals infected with foot and mouth disease virus. Moreover, radioactive isotopes of metals are widely used in medical therapy and diagnosis.