The place of gold compounds in the treatment of rheumatoid arthritis

Based upon current knowledge, it is concluded that although empirical, gold compounds may have a suppressive effect upon rheumatoid activity. Their usefulness is limited by uncertainty of therapeutic effect, slowness of action, and potential complications due to toxicity from the heavy metal. Recommendations for the selection of a gold compound for therapy, the schedule of administration, precautions during its use, and management of toxic reactions are presented. Although its action is less dependable, slower, and less potent than that of corticosteroid as an antirheumatic agent, there are many circumstances when administration of a gold compound is practical, reasonable, and beneficial for the treatment of rheumatoid arthritis. These circumstances have been evaluated. With increasing research into the nature of rheumatoid arthritis, it is to be expected that treatment will be improved. Until this happens, clinicians should employ the therapeutic agents available as wisely as possible. The physician who employs gold compounds for the treatment of rheumatoid arthritis should have a comprehensive understanding of this therapeutic agent and should recognize its limitations and potential hazards as well as its potential value.