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November 7, 1980

Searching for oral gold—for some arthritis patients

JAMA. 1980;244(18):2022-2027. doi:10.1001/jama.1980.03310180006004

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An experimental, orally administered compound containing 29% gold (by weight) is being studied as a possible alternative for some rheumatoid arthritis patients now receiving intramuscular injections of gold.

Among objections to the intramuscular injections are the inconvenience and cost of having to go to a physician for them, sometimes as frequently as once a week and for as long as ten to 20 weeks, after which monthly maintenance injections are required. Because gold is a heavy metal, the physician first must determine if the patient can tolerate these injections, then monitor skin appearance, blood cell count, and kidney function to guard against side effects.

For years, investigators have searched for a gold compound that could be taken by mouth and that might require less monitoring for possible side effects. The compound presently under study is called auranofin (2,3,4,6-tetra-O-acethyl-1-thio-B-D glucopyranosata-S-triethylphosphine-gold).

Clinical trials are in progress in the United States involving more