INJECTABLE GOLD COMPOUNDS - AN OVERVIEW

Injectable gold compounds have enjoyed widespread, but occasionally co ntroversial, use in rheumatoid arthritis since the 1920s. This overvie w examines the data from controlled trials and longer-term observation al studies. We conclude that gold is equivalent to other widely used s econd-line agents in terms of efficacy. Toxicity profiles are similar, apart from methotrexate. It is most efficacious and toxic in the firs t 2 yr of treatment. There appears to be a dose-response relationship for both efficacy and toxicity. Gold is one of the few agents that dec reases the rate of progression of erosions (RR 0.38, 95% CI 0.23-0.64) . Gold compounds, therefore, have a definite place in the rheumatologi st's armamentarium, but further research is required to determine opti mal monitoring regimes as well as the role of maintenance therapy and combination therapy.