Synopsis

Source of validity: Scientific
Rating (out of 5): 2

Gold compounds, specifically injectable forms such as gold sodium thiomalate and auranofin (oral), have a longstanding history in the treatment of rheumatoid arthritis (RA). Their use began in the 1920s, predating many modern disease-modifying antirheumatic drugs (DMARDs). The scientific rationale for their use is based on their ability to modulate immune function and reduce inflammation. Clinical trials in the mid-to-late 20th century demonstrated that gold therapy could reduce symptoms and slow joint damage in some RA patients. However, the efficacy was modest compared to more recent therapies, and gold compounds are associated with significant side effects, including dermatitis, stomatitis, and kidney toxicity.

Gold therapy has fallen out of favor due to the advent of safer and more effective DMARDs such as methotrexate and biologic agents. Current guidelines rarely recommend gold compounds, and they are seldom used in modern clinical practice. Nevertheless, the use of gold for RA is scientifically validated based on historical clinical data, even if it is now largely obsolete. The strength of evidence supporting their benefit is moderate (rated here as 2 out of 5), reflecting both the limitations of older studies and the availability of better alternatives today.

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