Low-dose methotrexate compared with auranofin in adult rheumatoid arthritis: a thirty-six-week, double-blind trial

Several studies have shown that the drug methotrexate is effective in treating rheumatoid arthritis, an inflammatory joint disease, particularly in patients who are not responsive to conventional therapy. Methotrexate treatment is associated with sustained effectiveness, a decrease in the dose of corticosteroids needed to counteract inflammation, tolerable levels of toxicity, and improved measures of disease severity, such as the erythrocyte sedimentation rate. Studies have shown that methotrexate is more effective and causes more rapid improvement than another agent, azathioprine, used to treat rheumatoid arthritis. The effectiveness of methotrexate was compared with that of the drug auranofin in 281 patients with active rheumatoid arthritis over a 36-week period. Both drugs were effective in treating rheumatoid arthritis, although the effect of methotrexate was greater and occurred earlier than that of auranofin. Methotrexate caused significantly greater improvement in terms of alleviating pain and swelling of joints and reducing disease activity, as assessed by patients and physicians. Auranofin caused more adverse effects and a greater frequency of patients withdrawing from the study due to toxicity of the drug. The findings suggest that methotrexate is more effective and better tolerated than auranofin. (Consumer Summary produced by Reliance Medical Information, Inc.)