Sodium aurothiomalate


Sodium aurothiomalate is a gold compound that is used for its immunosuppressive anti-rheumatic effects. Along with an orally-administered gold salt, auranofin, it is one of only two gold compounds currently employed in modern medicine.

Medical uses

It is primarily given once or twice weekly by intramuscular injection for moderate-severe rheumatoid arthritis although it has also proven itself effective in treating tuberculosis.

Adverse effects

Its most common side effects are digestive, vasomotor or dermatologic in nature, although conjunctivitis, blood dyscrasias, kidney damage, joint pain, muscle aches/pains and liver dysfunction are also common. Less commonly, it can cause GI bleeds, dry mucous membranes and gingivitis. Rarely it can cause: aplastic anaemia, ulcerative enterocolitis, difficulty swallowing, angiooedema, pneumonitis, pulmonary fibrosis, hepatotoxicity, cholestatic jaundice, peripheral neuropathy, Guillain–Barré syndrome, encephalopathy, encephalitis and photosensitivity.

Pharmacology

Its precise mechanism of action is unknown but is known that it inhibits the synthesis of prostaglandins. It also modulates phagocytic cells and inhibits class II major histocompatibility complex-peptide interactions. It is also known that it inhibits the following enzymes:
Reports of favorable use of the compound were published in France in 1929 by Jacques Forestier. The use of gold salts was then a controversial treatment and was not immediately accepted by the international community. Success was found in the treatment of Raoul Dufy's joint pain by the use of gold salts in 1940; " brought in a few weeks such a spectacular sense of healing, that Dufy... boasted of again having the ability to catch a tram on the move."
It was recently discontinued from the US market along with aurothioglucose leaving only auranofin as the only gold salt on the US market.