gold in rheumatoid arthritis

Last reviewed 01/2018

When using gold in RA, the following should be noted:

  • therapeutic effects of gold salts develop slowly - maximum response is reached after 4-6 months treatment

  • i.m. gold:
    • a 10mg test dose is first given - this is necessary to exclude hypersensitivity
    • test dose followed by 50mg i.m. weekly until response occurs
    • change in dosage interval is undertaken 3-monthly because of lead-time in clinical response to change in dose
    • if no response after 1000mg total dose then treatment should be discontinued
    • if response to gold i.m. then:
      • monthly doses while arthritis persists
      • maintain for 5 years after complete remission

  • oral gold:
    • dose:
      • initial 3mg/daily for 4 weeks
      • maintenance 3mg bd
      • if no response to can be increased to 3mg tds

    • oral preparation has fewer side effects than i.m.
    • most common side effect is diarrhoea