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KMID : 0378019810240120123
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New Medical Journal
1981 Volume.24 No. 12 p.123 ~ p.130
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Chrysotherapy for Rheumatoid Arthritis
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Abstract
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Gold salt therapy, which is still one of the most effective treatment in rheumatoid arthritis, has been used inadequately because of unpredictable way in which it improved the disease and the very rare but severe toxic or lethal side effects affecting, kidney and hematopoietic system.
There has been much endeavors to find newer gold preparation and effective plan of it´s administration that is more potent but less toxic in the treatment of rheumatoid arthritis.
In this study, clinical experience of gold salt therapy for 24 patients who had been treated at the department of orthopaedic surgery, Catholic Medical College & Center is presented.
Two different kinds of preparations were used; triethylphosphine gold compound (Auranofin) that is administered by mouth and gold sodium thiomalate (Myochrisin) that was given intramuscularly.
Patients were divided into 3 groups arbitrarily; patients in group I received 3mg of Auranofin, twice daily for 4 weeks and thereafter 2mg for 22 weeks. Patients in group II received 3mg of Auranofin twice daily for 26 weeks and patients in group III received 10mg of Myochrisin weekly increasing to 25mg in 3rd week and thereafter 50mg up to total amount of lgm by traditional method.
The result were as follows;
1. Blood gold level was always highest in group III during observation period and at 12 weeks, it was 4 to 5 times higher than that of group I and group II.
2. Favorable response was observed 6 in group I, 5 in group II and 6 in group III. Clinical remission was noticed 2 in group I, one in group II and 2 in group III.
3. Beneficial effect of gold preparation appeared at average 7.7 weeks ~ in group I, 6.0 weeks in group II and 9.4 weeks in group III.
4. Adverse reaction was noticed in 70.800 of patients but it was transient except one case in group III that exhibited severe mucocutaneous lesion and subsequent withholding of therapy was necessary.
5. Mucocutaneous lesion was commonest adverse reaction and gastrointestinal disturbance was next in frequency. But there were no statistically significant changes in laboratory data.
6. The author could administer gold prepararions safely by careful clinical observation and repetitive laboratory examination for the early detection of the adverse reaction which might be elicited or complicated during the treatment.
7. Favorable responses in group I and group II were observed that were comparable to that in group III in spites of lower blood gold level.
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