INCREASING THE EFFECTIVENESS OF GOLD THERAPY IN RHEUMATOID ARTHRITIS

Abstract

A logical basis for aurotherapy in rheumatoid arthritis is found in a study of the rate of urinary excretion of the injected gold. A total of 138 urinary excretion assays for gold were made in patients who were being treated with intramuscular injections of gold sodium thiomalate or aurothioglucose at different dosage levels. The results confirmed the findings of previous workers that the amount of gold excreted was greater, the greater the amount administered. The highest rate occurred on the day of injection, and about one-seventh of the quantity injected was excreted in the first week. Since individual patients differed in their excretion rates for gold, any fixed dosage schedule must result in toxic symptoms in some and therapeutic failure in others. Toxicity to gold salts was found not to be a serious hazard. It was reversible, and its appearance was a criterion for the adequacy of the dosage. A comparative study of 347 patients showed that individualized programs of therapy were more effective than standard programs. Individualized programs induced remissions in 82% of the cases. The remissions occurred after 12 to 18 weeks of treatment and were made lasting by continuing the dosage at a maintenance level for eight months.