According to medical research, gold preparations for the treatment of rheumatic diseases currently occupy the first line of the rating by effectiveness among other basic medicines. In most patients, their use helps to achieve significant improvement, in an impressive percentage of cases - persistent remission. On average, treatment with gold-based compounds is successful in 80% of patients. In medical practice, for arthritis of a rheumatic nature, gold compounds have been actively used since 1929.
general information
At present, the exact mechanism according to which preparations containing gold affect the human body has not been established. Presumably, these substances accumulate in phagocytes of the mononuclear type. Analyzes revealed an increased concentration of compounds in the synovial articular membrane. In these organic tissues, medications persist for a long time, slowing down the activity of macrophages, neutrophils, and the presentation of antibodies to T-helpers. Pathological immune reactions become less active, and the generation of rheumatoid factor slows down. The production of prostaglandins responsible for activating the inflammatory focus becomes less pronounced.
It has been established that gold salts are drugs that can slow the progress of rheumatoid arthritis. The most pronounced effect is given by a long medication course. The tool can cause remission, lasting in some cases up to five years. In some situations, drug therapy helps to normalize the structure of bones affected by erosion. Positive progress is accompanied by a weakening of the pain syndrome, and ESR returns to normal in the circulatory system. The use of such a group of medicines allows you to abandon non-hormonal anti-inflammatory compounds.
When will it help?
Gold preparations are prescribed for rheumatoid arthritis of the articular form. To resort to these funds (quite toxic to the body) should only be if the long course of treatment with non-hormonal anti-inflammatory drugs has not shown the desired effect. Gold-based products cannot be dispensed with if arthritis is prone to rapid progress, is very aggressive, and bone erosion occurs early. The more significant the titers of the rheumatoid factor, the more justified the appointment of such drugs in a particular case.
Gold treatment is practiced if rheumatoid arthritis is confirmed, there is no doubt about the diagnosis and cannot be. You can not start using the tool in the first six weeks of the progress of the disease, since there is a likelihood of an erroneous definition of pathology. The most effective drug course gives at an early stage of the disease. Persistent contracture, the consequences of arthritis, deformity - all this with such drugs can not be corrected. In the case of the seronegative type, the considered group of drugs is relatively ineffective.
Chrysanol
This gold preparation for the treatment of rheumatoid arthritis is based on calcium gluconate, which accounts for a third of the total volume, and calcium aurothiopropanol sulfonate, which is 70% in the medication. On sale is a five percent suspension in oil. The manufacturer prepares the product in ampoules for single use, the volume of one copy is 2 ml. The medication is intended for introduction into muscle tissue. One milliliter contains 17 mg of gold.
When planning the use of colloidal gold preparations, however, like any other, it is first necessary to check the body's response to the drug course. Assuming that Chrysanol is optimal for treatment, you must first put a test injection into muscle tissue. The patient is injected with a five percent solution in an amount of a milliliter or half as much, after seven days the procedure is repeated. With adequate tolerance, the drug continues to be used once a week, increasing the dosage to a standard 2 ml. The duration of the treatment program reaches eight months.
Continuing therapy
With good tolerance and pronounced effectiveness, the Chrysanol gold preparation is used further, making two-week intervals between the administration procedures. For one injection, 2 ml of the drug is administered to the patient. The duration of this stage reaches four months. With a significant improvement in condition, a convincing and persistent remission, the intervals are increased to three weeks, while maintaining the same dosage.
The total drug course lasts a year, two, sometimes longer, almost without interruption. This is practiced only if there is a convincing improvement in the patient's condition. The first shifts can usually be noticed after four months of regular injection of Chrysanol injections, that is, at the stage of receiving patients a total of 200-400 mg of the main substance. Further signs of improvement should increase.
Sanokrizin and Myocrisin
Both of these medicines are effective for rheumatoid arthritis. A gold product called "Sanokrizin" is used according to a similar program previously described. Designed for intramuscular injection. A single dosage is 50 mg, of which half of the volume is gold.
Under the name "Myocrisin" in pharmacies, the drug is presented in ampoules for injection. One introduction involves obtaining 20-50 mg of the drug, which contains 10-25 mg of gold. The chemical component that provides the tool with effectiveness is aurothio-malic acid, sodium salt. To test tolerance, the agent is used in an amount of 20 mg. As part of the main therapeutic course, a single dosage is 50 mg. The drug is intended for introduction into muscle tissue.
Auranofin
This tool is also known under the name "Ridaura." The gold drug for rheumatoid arthritis is taken orally. A tablet medication is on sale; one copy contains 0.003 g of the active ingredient. For a day, 6 mg are shown, divided into two stages. If tolerance is satisfactory, the therapeutic course shows a pronounced result, the drug program will be indefinite in duration - sometimes six months, sometimes one and a half, sometimes even more.
Consequences: positive and negative
Liquid gold preparations can provoke quite undesirable and severe adverse reactions. Approximately one in ten patients against the background of a therapeutic course is faced with inflammatory processes on the oral mucosa, itchy areas covered with rashes appear on the skin. With a frequency of one case, for every 10-100 people, hair loss, inflammation of the ocular cornea, and fever occur. The frequency of occurrence of renal disorders is similar - nephrotic syndrome, the presence of protein inclusions in urine.
Liquid gold medications can cause stool problems. Particularly high is the likelihood of such a side effect if Auranofin is selected. On average, 1-10% of patients have aplastic anemia. The use of gold compounds is associated with the likelihood of liver damage, leuko, thrombocytopenia.
If the patient is prescribed a medication with gold-based agents, urine and blood samples should be regularly taken for general and biochemical studies. Urgent cancellation requires a condition in which the concentration of protein fractions in urine exceeds 0.2 g / l, red blood cells - 5-10 g / l. It is important to check the functionality of the liver, analyze the activity of enzymes.
Strongly impossible!
Gold preparations are not used if rheumatoid arthritis is accompanied by exhaustion, vasculitis or visceritis accompany it. You can not use such funds for persistent violation of the functionality of the gastrointestinal tract, skin, liver, and renal system. Do not treat pregnant women, patients suffering from hemocytopenia.
The nuances of therapy
If the use of gold preparations has caused complications, it is necessary to adjust the condition using a five percent solution of unitiol. The drug is injected into muscle tissue, a single dosage is 5 ml. In some cases, the optimal course is Prednisolone. The substance is prescribed for a day in the amount of 15-60 mg. This is more often practiced if taking funds on gold has caused hemocytopenia. In addition, the main course is canceled.
If a seronegative type of arthritis is established, a gold tolerance test can be performed, but usually the patientโs reaction is negative.
Tauredon
Under this name, a gold preparation is made that inhibits the generation of lymphocyte antibodies. In addition, the work of plasma cells is controlled. "Tauredon" - the basic version of the correction of autoimmune pathologies. Under its influence, the antigeninductive activity of lymphocytes slows down, phagocytosis is inhibited, membranes are stabilized, collagen is strengthened. On average, clinical manifestations of improvement can be first noticed at week 9-17 of the course, by the time the patient has already received a total of 300-800 mg.
After injection, the gold drug in the blood is recorded at a maximum concentration approximately four hours after the injection. Sometimes the indicators are achievable after 3 hours, in other cases it takes twice as much time. Increased accumulation of gold is noted in the reticuloendothelial system. A fairly high content is established in the adrenal glands, certain renal tissues. The level of drug accumulation in the skeletal system and muscle tissues is low.
The nuances of kinetics
Soon after administration, Tauredon reacts with serum albumin, and binds almost completely. A day after the injection, up to 80% of the maximum concentration is observed in serum. 83-90% of the main compound is eliminated by the kidneys, other volumes - through the intestinal tract.
It is possible to achieve equilibrium concentration at a single dosage of 50 mg on average after a month and a half. If you use Tauredon twice a week, introducing 25 mg of the drug, before the next procedure in the circulatory system, the concentration of the substance is estimated at about 3.5 ฮผg / ml.
The elimination half-life is estimated at an average of 27 days.
When and how will it help?
"Tauredon" is prescribed for rheumatoid youthful, psoriatic arthritis. The gold preparation is indicated for deep introduction into muscle tissue. During the procedure, it is necessary to use strictly sterile disposable devices. It is forbidden to heat the medication before administration.
At the moment there is no systematic information on the optimal dosage of Tauredon, there is no information on the basis of which the remedy could be prescribed. Recommended doses cannot be called standard. In each case, you need to choose the format of treatment, focusing on the reaction of the patient.
The primary stage is a trial, aimed at determining the optimal dosage. It is necessary to assess the level of tolerance, select the appropriate volumes. First, Tauredon is used in a minimum concentration, gradually achieving saturation of the body, after which a supportive course is practiced, due to which a stable level of gold is maintained in the body.
Treatment: adults
At first, Tauredon is used twice a week. The first, second, third injections contain 10 mg of medication, the next three - twice as much. From the seventh procedure, 50 mg of the drug can be administered twice a week, or twice as much once a week. This dosage is maintained until a pronounced clinical effect is observed. It is unacceptable to exceed the maximum permissible amount of active substance - 1.6 g. If, as soon as this amount is achieved, it is not possible to see an improvement, the therapy is canceled.
When observing efficacy, Tauredon is used every two weeks in an amount of 50 mg or once a month in twice the concentration to maintain the result. This course lasts for months, years. Duration is determined by the activity of the pathology. As necessary, adjust the dosage, focusing on the patient's condition. Do not exceed maximum quantities for adults.
Children: special occasion
For minors, doses of Tauredon are selected based on weight. Initially, 0.7-1.0 mg of active substance is prescribed for each kilogram of mass. When it was possible to achieve an effect, supportive therapy is practiced, 1-2 times a month, putting injections of the substance in the amount of milligrams per kilogram.
If the childโs weight is less than 20 kg, 5 mg is used once in the first week, then 10 mg is administered from 11 to 24 weeks in a row, after which injections of the drug in the amount of milligram per kilogram are administered once every two weeks. If the pathological process gradually fades, between the injections, the intervals are increased from two to three, then up to four weeks.
With a weight of 20-30 kg, at first 10 mg of the drug is prescribed, then twice as much for a period of 11 to 24 weeks, after which a maintenance dose calculated based on weight is administered every two weeks.
Risks and Dangers
Like other gold preparations, Tauredona can cause skin adverse reactions. The use of a medication is associated with the danger of inflammatory processes in the oral mucosa. Dermatitis is possible, certain areas of the skin may itch. There is a risk of protein inclusions in urine. Anemia is possible, leuko-, thrombocytopenia may develop, in some hematopoiesis is lost. All these negative effects are quite common (up to 10% of patients note something from the specified list).
It was revealed that Tauredon can in rare cases cause Steven-Johnson, Lyell, and other severe forms of inflammatory and skin reactions. There is a risk of encephalopathy while taking gold medications - this is specific nephritis, accompanied by nephrotic syndrome. There is a risk of pancytopenia, aplastic type anemia.
Isolated cases of occurrence against the background of the use of gold preparations of an inflammatory focus in the bronchi, alveoli are known. There is a risk of stomach cramps, enterocolitis, pulmonary fibrosis, lichen planus. Possible necrotic processes in the liver cells, immunosuppression, lack of immunoglobulins, neuropathy, impaired integrity and functionality of the retina, nervous system of the eye. They may lose their color, begin to exfoliate nails. Such responses to treatment are extremely rare and serve as an indication for urgent cancellation of the course.
Do I need this?
There are many reviews of gold preparations, since the practice of their use is quite wide. Mostly, patients using the formulations under the guidance of a doctor noted that the improvement was significant enough so that the negative effects did not interfere with continued therapy. Independent use has always led to an undesirable result.
Gold is different
By the way, in pharmacies you can find the drug "Black Gold". It has nothing to do with the drugs used against rheumatoid arthritis, and is intended for men who want to increase their sexual activity. The tool contains relatively safe components, however, before using it, consult a specialist, as there is a risk of a negative response from the body. To avoid unpleasant surprises, it is recommended that you first come to an appointment with your doctor.
Gold preparations for ceramics are common. Such are not at all intended for treating people, but they are used in industry and art crafts. The compositions are designed for the treatment of ceramic surfaces, spectacular and refined decoration of works of art.