Comparison of auranofin, gold sodium thiomalate, and placebo in the treatment of rheumatoid arthritis

Ward, John; Williams, H. James; Boyce, Eric G.; Egger, Marlene J.; Reading, James C.; Samuelson, Cecil O.

doi:10.1016/0002-9343(83)90486-2

Cited by 49 publications

(70 citation statements)

References 20 publications

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“…Two hundred eight patients met entry criteria and were comparable for age, sex, and disease severity (15). One hundred sixty-one patients completed at least 20 weeks of treatment.…”

Section: Resultsmentioning

confidence: 99%

“…In addition, more GST-treated patients experienced toxic reactions during this study. Also, an analysis of the time-course of response to both forms of chrysotherapy suggests that the proportion of patients who achieved meaningful improvement by week 21 of therapy does not represent the total population of patients who will achieve this degree of response if therapy is continued (25).…”

Section: Joint Swellingmentioning

confidence: 99%

“…To further clarify the value of routinely quantitating gold concentrations in the treatment of patients with RA, whole blood gold concentrations were determined at regular intervals and were correlated with clinical outcomes during a controlled, randomized, multicenter trial comparing gold sodium thiomalate (GST), auranofin, and placebo in the management of RA, which was performed by the Cooperative Systematic Studies of Rheumatic Diseases Program (15).…”

mentioning

confidence: 99%

“…ized, parallel trial comparing placebo, auranofin, and GST in the treatment of active, persistent RA (15).…”

mentioning

confidence: 99%

“…Physician assessments included: I ) joint count for tenderness on pressure and/or pain on motion for 68 diarthrodial joints, graded on a scale of 0 = none, 1 = positive response on questioning, 2 = spontaneous response elicited, and 3 = withdrawal by patient on examination; and 2) joint swelling for 66 diarthrodial joints, graded on a scale of 0 = none, 1 = detectable synovial thickening without loss of bony contours, 2 = loss of distinctness of bony contours, and 3 = bulging synovial proliferation with cystic characteristics. Additional assessments have been summarized and published previously (15). Laboratory studies.…”

mentioning

confidence: 99%

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Lack of correlation between blood gold concentrations and clinical response in patients with definite or classic rheumatoid arthritis receiving auranofin or gold sodium thiomalate

Dahl¹,

Coleman²,

Williams³

et al. 1985

Arthritis & Rheumatism

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We investigated the correlation between whole blood gold concentrations and clinical outcomes in 59 auranofin-treated patients and 51 gold sodium thiomalate-treated patients who completed a 21-week, placebocontrolled, multicenter parallel trial. Whole blood gold concentrations did not correlate with clinical outcome, as assessed by changes in joint tenderness, joint swelling, 'or Westergren erythrocyte sedimentation rate. They also did not correlate with toxic reactions necessitating withdrawal from the study.Chrysotherapy has been used for the symptomatic management of rheumatoid arthritis (RA) for more than 50 years and has been accepted as an effective treatment modality for the past 20 years (1,2). In general, two-thirds of RA patients who tolerate gold therapy respond favorably (3). The reasons for lack of response in one-third of the gold-treated patients and the wide variability in the degree of improvement observed in those patients who do respond remain unclear. Clinical features, such as age, gender, or race, and laboratory variables, such as presence of rheumatoid factor, magnitude of erythrocyte sedimentation From the Cooperative Systematic Studies of Rheumatic

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“…Two hundred eight patients met entry criteria and were comparable for age, sex, and disease severity (15). One hundred sixty-one patients completed at least 20 weeks of treatment.…”

Section: Resultsmentioning

confidence: 99%

Section: Joint Swellingmentioning

confidence: 99%

mentioning

confidence: 99%

“…ized, parallel trial comparing placebo, auranofin, and GST in the treatment of active, persistent RA (15).…”

mentioning

confidence: 99%

mentioning

confidence: 99%

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Lack of correlation between blood gold concentrations and clinical response in patients with definite or classic rheumatoid arthritis receiving auranofin or gold sodium thiomalate

Dahl¹,

Coleman²,

Williams³

et al. 1985

Arthritis & Rheumatism

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Monotreatment With Conventional Antirheumatic Drugs or Glucocorticoids in Rheumatoid Arthritis

Guski,

Jürgens,

Pedder

et al. 2023

JAMA Netw Open

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ImportanceThis is the first network meta-analysis to assess outcomes associated with multiple conventional synthetic disease-modifying antirheumatic drugs and glucocorticoid.ObjectiveTo analyze clinical outcomes after treatment with conventional synthetic disease-modifying antirheumatic drugs and glucocorticoid among patients with rheumatoid arthritis.Data SourcesWith no time restraint, English language articles were searched in MEDLINE, Embase, Cochrane Central, ClinicalTrials.gov, and reference lists of relevant meta-analyses until September 15, 2022.Study SelectionFour reviewers in pairs of 2 independently included controlled studies randomizing patients with rheumatoid arthritis to mono–conventional synthetic disease-modifying antirheumatic drugs, glucocorticoid, placebo, or nonactive treatment that recorded at least 1 outcome of tender joint count, swollen joint count, erythrocyte sedimentation rate, and C-reactive protein level. Of 1098 assessed articles, 130 articles (132 interventions) were included.Data Extraction and SynthesisThe review followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses reporting guideline, and data quality was assessed by the Cochrane risk of bias tool RoB 2. Data were extracted by a single author and checked independently by 2 authors. Data were analyzed using a random effect model, and data analysis was conducted from June 2021 to February 2023.Main Outcomes and MeasuresA protocol with hypothesis and study plan was registered before data recording. The most complete of recorded outcomes (tender joint count) was used as primary outcome, with imputations based on other outcomes to obtain a full analysis of all studies. Absolute change adjusted for baseline disease activity was assessed.ResultsA total of 29 interventions in 275 treatment groups among 132 randomized clinical trials (mean [range], 71.0% [27.0% to 100%] females in studies; mean [range] of ages in studies, 53 [36 to 70] years) were identified, which included 13 260 patients with rheumatoid arthritis. The mean (range) duration of RA was 79 (2 to 243) months, and the mean (range) disease activity score was 6.3 (4.0 to 8.8). Compared with placebo, oral methotrexate was associated with a reduced tender joint count by 5.18 joints (95% credible interval [CrI], 4.07 to 6.28 joints). Compared with methotrexate, glucocorticoid (−2.54 joints; 95% CrI, −5.16 to 0.08 joints) and remaining drugs except cyclophosphamide (6.08 joints; 95% CrI, 0.44 to 11.66 joints) were associated with similar or lower tender joint counts.Conclusions and RelevanceThis study’s results support the present role of methotrexate as the primary reference conventional synthetic disease-modifying antirheumatic drug.

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Injectable gold for rheumatoid arthritis

Clark

Tugwell

Bennet

et al. 1997

Cochrane Database of Systematic Reviews

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Comparison of auranofin, gold sodium thiomalate, and placebo in the treatment of rheumatoid arthritis

Cited by 49 publications

References 20 publications

Lack of correlation between blood gold concentrations and clinical response in patients with definite or classic rheumatoid arthritis receiving auranofin or gold sodium thiomalate

Lack of correlation between blood gold concentrations and clinical response in patients with definite or classic rheumatoid arthritis receiving auranofin or gold sodium thiomalate

Monotreatment With Conventional Antirheumatic Drugs or Glucocorticoids in Rheumatoid Arthritis

Injectable gold for rheumatoid arthritis

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