As Bright as Gold
RATE

It was 1989. I was living in a smallish city on the North Sea in Northern Germany with my little daughter and my Air Force husband. I had a full-time Army Public Relations job with the Dept. of Defense that I loved, right there on the U.S. Army Kaserne.

For the last two years rheumatoid disease had been an unwelcome and sometimes devastating part of my life, frequently causing my joints, large and small, to stiffen, swell, and become exquisitely, sometimes terrifyingly painful.

When it flared—which was often–my RD sometimes disabled me. It could prevent me from working, from taking care of my family, and definitely from enjoying my life.

My doctor, a young U.S. Army internist, treated my RD with one non-steroidal anti-inflammatory drug (NSAID) after another, starting with aspirin. We tried a couple of disease-modifying anti-rheumatic drugs (DMARDs), like hydroxychloroquine, as well. So far, nothing had worked to bring the disease under control—not even a little.

What ended up giving me relief

Unfortunately, the only drugs that gave me any relief were opioids, but my doctor was reluctant and frugal about prescribing them. Frustrated, I finally asked him if he could refer me to a local German rheumatologist for a second opinion and, maybe, some new ideas about treatment.

He could, and he did.

Gold – an older DMARD therapy?

The German rheumatologist put me through the most thorough exam I’d had yet, along with drawing blood for tests. A week later he suggested I should try gold therapy, explaining in a careful accented English, that this older DMARD was sometimes effective in suppressing the inflammation that was causing the pain—and eventually damage—in my joints. It might even slow the progression of my disease. He wrote me a prescription, and I took it to my U.S. Army doctor, who submitted it to the military medical system for approval.

After a few more weeks, my new therapy arrived at the military pharmacy in the form of tablets (Auranofin; trade name: Ridaura). I was relieved, as my doctor had informed me solemnly that gold therapy was most often administered as a rather painful, weekly intramuscular injection. I didn’t much like shots—who does?—but I resigned myself to enduring them. I was in so much pain that I was ready to do anything to stop it.

I took the oral version of gold for a year. Required during that time: having my blood drawn and tested every two weeks to make sure it wasn’t damaging my liver or causing other serious problems in my body. Other than some initial nausea, side-effects never bothered me.

But in the end, like the other drugs I’d taken, gold had absolutely no effect on my RD. Years later, while researching rheumatoid disease and its treatments online, I’d learn that by the 1990s, most U.S. rheumatologists had stopped prescribing it to their patients.

You can imagine my surprise, then, when I recently ran across an article on the Clinical Pain Advisor webpage about gold therapy for RD, suggesting that this old, back-shelved drug was experiencing a sort of renaissance. New research, the article stated, now shows that gold therapy still can work for some patients.

I’ve always wondered why gold—which I, like most people, associate with my wedding band and other jewelry, piles of doubloons in pirates’ chests, and dental fillings—could possibly be used as a medicine. The CPA article explained:

“Because of its purity, gold is an inert element when used in the human body. This biocompatibility has made it extremely useful in many areas of dentistry and medicine. Its anti-inflammatory and antimicrobial actions have since been widely recognized.

“The mechanisms whereby gold compounds exert anti-inflammatory effects are not fully understood, but mounting evidence indicates that gold is stored in lysosomes in which it inhibits the processing of antigenic agents and the release of inflammatory cytokines.”

Great. But why did it fall out of favor? It seems that as medical science developed more efficacious DMARDs, and then the first biologics in the early 2000s, poor old gold therapy lost its luster.

Now, however, researchers are discovering new ways to use gold therapy in RD.

“In a systematic review of auranofin [oral gold] for the treatment of rheumatoid arthritis, this gold compound was found to be more efficacious than placebo in relieving tender joints, pain, and reducing erythrocyte sedimentation rate,” the article states.

“In a 48-week randomized, placebo-controlled trial, researchers examined the effects of a combination of oral methotrexate and intramuscular gold therapy in patients with rheumatoid arthritis whose disease was not sufficiently controlled by methotrexate alone. Significant clinical improvement was reported after adding intramuscular gold therapy to methotrexate.”

And RD isn’t the only use they’re finding for gold. Researchers have discovered that it’s useful as a cancer treatment; as an anti-microbial agent; and excitingly, that it can inhibit the growth of methicillin-resistant Staphylococcus aureus, or MRSA.

Seems that the old treatment I took for my rheumatoid disease way back in the late 80s is becoming golden once again.

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