Pharmacology and Mechanism of Action

Gold may be prescribed either orally (auranofin) or parenterally (as aurothiomalate or aur-othioglucose). Gold is highly protein-bound to albumin. Peak blood concentrations are reached after two to six hours. Plasma half-life is around seven days for a 50 mg dose (37). Again, the mechanism of action is unclear but is thought to be via effects on neutrophils and monocytes (37). Gold is considered to be as effective for RA as either sulfasalazine or MTX. It has, however, a higher rate of treatment withdrawal for side effects when compared with other drugs, such as sulfasalazine (49).

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