[Comparison of oral and parenteral gold therapy--review of the literature].

Numerous open and placebo-controlled trials have shown Auranofin, an oral gold salt, to be effective in the base-line treatment of rheumatoid arthritis. In comparative trials the drug was found to be somewhat less potent than sodium aurothiomalate. Whether it is equal or superior to other base-line antirheumatoids like D-penicillamine or antimalarials, can as yet not be established because of the small patient groups involved in the published trials. While adequately effective clinically, oral gold salts, like their parenteral counterparts, do not halt the radiological progression of rheumatoid lesions. Overall, Auranofin is much better tolerated than the parenteral gold salts, although soft feces are more commonly seen and diarrhea may occur occasionally. Skin rashes as well as proteinuria and thrombocytopenia have been reported in some instances so that, as during parenteral treatment, laboratory studies at regular intervals are mandatory. On account of its oral dosage form and its low side-effect rate Auranofin is a true alternative to conventional parenteral gold salt therapy.