Health Library Gold Salts for Rheumatoid ArthritisFrom Healthwise

Oral (by mouth)

Intramuscular (by a shot or injection)

It is not understood exactly how gold works to treat rheumatoid arthritis. However, gold salts appear to accumulate slowly in the body and, over time, they reduce inflammation and slow the progression of rheumatoid arthritis.

Gold injections are given every week for the first 22 weeks. After that, gold may be given less often if it is working.¹

Gold is used to reduce inflammation and slow disease progression in people with rheumatoid arthritis. Gold is not usually the first treatment given to people with rheumatoid arthritis, since methotrexate and other DMARDs are available.

A review reports that treatment with intramuscular gold (parenteral gold) reduces disease activity and joint inflammation.²

Gold salts taken by mouth (oral) have not been found to be as effective as gold injections, and it can take up to 6 months before benefits are noticed from oral gold salts.¹

Side effects may develop after a significant amount of gold has accumulated in the body.

Oral gold has fewer side effects than gold injected into the muscle. Common side effects of oral gold include:

• Decreased appetite, nausea, and diarrhea.
• Problems with the skin, blood, kidneys, or lungs (rare).

Common side effects of injected gold include:

• An itchy skin rash.
• Mouth sores.

Rarer side effects include:

• Kidney problems (kidney damage that causes loss of protein in the urine).
• Suppression of blood cell production, which may increase the risk of infection or serious bleeding. (A return to normal blood cell production may take several weeks after the drug is no longer taken.)

Extremely rare side effects include bowel or lung inflammation.

See Drug Reference for a full list of side effects. (Drug Reference is not available in all systems.)

It can take 3 to 6 months before gold treatment improves symptoms.

Regular urine tests to check for protein (indicating kidney damage) and blood tests are needed.

Complete the new medication information form (PDF)(What is a PDF document?) to help you understand this medication.

Citations

1. Kwoh CK, et al. (2002). Guidelines for the management of rheumatoid arthritis. Arthritis and Rheumatism, 46(2): 328–346.

2. Emery P, Suarez-Almazor M (2002). Rheumatoid arthritis. Clinical Evidence (10): 1454–1476.

Author:	Robin Parks, MS	Last Updated: August 23, 2006
Medical Review:	Kathleen Romito, MD - Family Medicine Stanford M. Shoor, MD - Rheumatology
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