Re: Re: What is gold treatment?

[Guest guest]

I also used to get gold injections back in the late 60's and early 70's and I believe they are still being used but are very rare. Methatrexate has been replacing the old gold salt injections and as I understand it, the reason they call it "gold" injection is because a small amount of gold was actually used in the mix.

[Guest guest]

I have also heard Methotrexate referred to as "the new gold standard" where this means the best available treatment and also a replacement for the former best treatment that actually used gold. I think many manufacturers stopped producing gold injections because of lack of demand. God bless.

----- Original Message -----

From: donbrndo@...

Rheumatoid Arthritis

Sent: Saturday, August 28, 2004 8:44 AM

Subject: Re: Re: What is gold treatment?

I also used to get gold injections back in the late 60's and early 70's and I believe they are still being used but are very rare. Methatrexate has been replacing the old gold salt injections and as I understand it, the reason they call it "gold" injection is because a small amount of gold was actually used in the mix.

[Guest guest]

In a message dated 8/28/2004 10:54:18 AM Central Standard Time, hvantuyl@... writes:

I have also heard Methotrexate referred to as "the new gold standard" where this means the best available treatment and also a replacement for the former best treatment that actually used gold. I think many manufacturers stopped producing gold injections because of lack of demand. God bless.

I have been taking Methotrexate for 2 months now and wasn't able to cut back on the Prednisone because of the pain. I am still taking 10 mg of Pred a day and am up to 6 MTX a week. I can't tell if the MTX is working at all. It doesn't seem like it.

My next appointment with the rheumy is Sept 7th.

How long can someone stay on Prednisone?

Are the other DMARDs only dosed with a needle?

Becky

Glaser & Soul are the Real Starsky & Hutch!

http://www.geocities.com/starskyhutch4evr

http://www.geocities.com/glasersoulfargas2004/

[Guest guest]

I've been on varying doses of Prednisone for over 3 years now. As high as doing injections with sol medrol, and as low as 2 mg/day. Right now I'm at 5 mg/day and holding okay. Still hoping to get back down to 2/mg, but I'm not willing to throw myself into a flare just to do that. I think that really low doses are okay for long term, but you should keep track of things like bone density, cholesterol levels and weight mgt.

Enbrel and Humira are self injected DMARDs. Remicade is given by IV.

gloria

[Guest guest]

Manufacturers are still producing gold salts, Myochrysine.

Gold salts are available here in Canada as well as in the United States. The Pack Arthritis Centre in Vancouver, BC even has a "gold clinic" to administer the gold and make sure there are not side effects. Gold is an incredibly old drug and works well for SOME PEOPLE with RA. Several forms of gold are available. When rheumatologists talk about ‘gold' they are usually referring to one of the injectable forms of gold salts: gold sodium thiomalate (Myochrysine, water based) and aurothioglucose (Solganal, oil based).

According to my Rheumy gold is quite commonly used in Canada still today. According to him Methotrexate is not a replacement per say to gold, but an alternative. For some people gold works really, really well and for others it does nothing at all.

Unfortunately I cannot tell you much about my experience with gold b/c I only got my first dosage and then found out that I am extremely allergic to it. But I wanted to respond to this message and let all of you out there know that gold salts are frequently used still. A few years back Solganal was discontinued in Canada Myochrysine was the gold of choice. Myochrysine is the gold that I tried and I can tell you it does have gold in it b/c I am very allergic to gold and I had an allergic response.

PS: Just read that Solganal is not being produced anymore anywhere and Myochrysine is backlogged with orders so there is a shortage in most pharmacy’s with info from March 2004, no further updates were found on the net.

A Q & A from the Arthritis Society’s website regarding gold injections and a response from a Rheumy cut and pasted below if you are interested.

Should I try gold again?Several years ago, I had gold injections for my rheumatoid arthritis (RA). After three months I developed an itchy rash, and the gold was stopped. Curiously, my RA went into a complete remission for two years but has now recurred. Other drugs have been helpful but my disease is not well controlled. Is gold still an option?

The Doctor Answers

Gold is one of the oldest disease-modifying antirheumatic drugs (DMARDs) used to treat RA. Two products are available: oil-based sodium aurothioglucose (Solganal) and water-based sodium aurothiomalate (Myochrysine). Both are given by weekly injection. An oral gold product is also available but is considered less effective and is rarely used in Canada.

Approximately 30 per cent of individuals who receive gold develop a minor side effect, such as itching, rash or mouth sores. Another five per cent develop other allergic reactions, probably to the gold itself. These side effects are normally dose-related and occur less often in patients receiving sodium aurothioglucose. Side effects such as rash, which are not potentially serious, can be managed by reducing the dose after a period of time when the drug isn't taken (a drug holiday).

The disadvantages of gold include the requirement for weekly injection and bothersome side effects, which typically occur during the first year of therapy. The safety of gold increases with long-term use. Also, laboratory tests must be done every two weeks for the first six months, then less frequently thereafter to monitor for asymptomatic side effects.

In my opinion, the many benefits of gold outweigh its disadvantages. There are no interactions with other medications, and it is safe to take when there is a possibility of pregnancy. I commonly recommend gold in moderate or severe RA because it's the only DMARD that can occasionally produce a complete remission. In patients with a partial response to gold, I often add methotrexate, commonly by injection with sodium aurothiomalate in the same syringe.Yes, it's worthwhile for you to have a second course of gold. However, don't expect a second remission because remissions occur in only 10 per cent of cases. But you can expect a marked improvement in your disease activity over time. Given your history of rash, I recommend that you do not receive the standard 50-mg weekly dose, but rather a 25-mg weekly injection that has been shown to be equally effective.

According to the Vancouver protocol (our treatment regimen for gold), injections are best given weekly until your arthritis is as good as it can be, until swelling, stiffness and ESR (a measurement for inflammation) have reached a plateau without change. At that point, you may reduce injections to every second week. However, about 30 per cent of my patients are best controlled with weekly injections indefinitely; their arthritis worsens when intervals between injections are increased. If you develop a rash or mouth sores, take a drug holiday until the side effects disappear, then restart at half the dose. In our clinic, even very low-dose gold can be remarkably effective if a higher dose causes skin reactions.

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[Guest guest]

Most people give up on Methotrexate or any other DMARD after 3 or 4 months without appreciable improvement but I have read of a person who took it for a year before noticing improvement. Also you should count from the last increase in your dosage and not from the time the medicine was first started. Bu giving up I mean increasing the dosage, changing to a different medication, or adding another medication. Often a combination of two or more DMARDs works better than any one alone.

I was on Prednisone starting at 40 mg and continuing at lesser amounts for about a year and a half till we finally found the right medicines and dosages to pretty well control my RA. For me it's 15 mg Methotrexate weekly plus 6 mg/kg Remicade every 8 weeks or so and I'm finally off Prednisone. You can stay on Prednisone as long as needed to function but you shouldn't take more than the minimum required for functioning. You also need to take calcium and Vitamin D to help rebuild the bone loss that goes along with Prednisone use. Prednisone is bad for you but not being able to function is worse in my opinion.

The biologics (Humira, Enbrel, Remicade, and Kineret) are given by needle and Methotrexate can be given my needle or by pill. Plaquenil and Sulfasalazine are generally milder than Methotrexate and are given by pill. Arava is roughly comparable to Methotrexate but newer and is given by pill. God bless.

----- Original Message -----

From: StarsHutch@...

Rheumatoid Arthritis

Sent: Saturday, August 28, 2004 8:05 PM

Subject: Re: Re: What is gold treatment?

I have been taking Methotrexate for 2 months now and wasn't able to cut back on the Prednisone because of the pain. I am still taking 10 mg of Pred a day and am up to 6 MTX a week. I can't tell if the MTX is working at all. It doesn't seem like it.My next appointment with the rheumy is Sept 7th.How long can someone stay on Prednisone? Are the other DMARDs only dosed with a needle? Becky Glaser & Soul are the Real Starsky & Hutch! http://www.geocities.com/starskyhutch4evrhttp://www.geocities.com/glasersoulfargas2004/

[Guest guest]

Hello, It's Eva,

I would like to say something about my experience with Prednisone. Women, please beware if you are also on Estrogen. It interacts with Prednisone. I did not realize it until after about 1 and a half years on Prednisone, my blood sugar started reading higher, my blood pressure started going up, I gained about 35 lbs., my fingernails started crumbling (prednisone keeps the body from absorbing calcium). Also the side effects of prednisone are worse if you also take estrogen. My Rheumy never told me this, neither did my PCP. I changed Rheumy's and he is weaning me off the prednisone and the withdrawals are not easy to deal with. I have been experiencing depression, joint pain is coming back, I feel kind of dizzy and out of focus and sometimes irritable, but I will put up with it rather than stay on prednisone.

I have been on Humira for over 6 months now and I believe it has helped me quite a bit and according to my blood work, the RA factor and inflammation has gone down and I am in remission. I also take one Mobic per day. The new doc will add some other kind of med to help with the joint pain returning.

It seems like there is always a price to pay with the meds and we are all taking a chance to get out of this senseless pain and suffering.

God Bless and be careful.

Eva

----- Original Message -----

From: Harold Van Tuyl

Rheumatoid Arthritis

Sent: Saturday, August 28, 2004 11:52 PM

Subject: Re: Re: What is gold treatment?

Most people give up on Methotrexate or any other DMARD after 3 or 4 months without appreciable improvement but I have read of a person who took it for a year before noticing improvement. Also you should count from the last increase in your dosage and not from the time the medicine was first started. Bu giving up I mean increasing the dosage, changing to a different medication, or adding another medication. Often a combination of two or more DMARDs works better than any one alone.

I was on Prednisone starting at 40 mg and continuing at lesser amounts for about a year and a half till we finally found the right medicines and dosages to pretty well control my RA. For me it's 15 mg Methotrexate weekly plus 6 mg/kg Remicade every 8 weeks or so and I'm finally off Prednisone. You can stay on Prednisone as long as needed to function but you shouldn't take more than the minimum required for functioning. You also need to take calcium and Vitamin D to help rebuild the bone loss that goes along with Prednisone use. Prednisone is bad for you but not being able to function is worse in my opinion.

The biologics (Humira, Enbrel, Remicade, and Kineret) are given by needle and Methotrexate can be given my needle or by pill. Plaquenil and Sulfasalazine are generally milder than Methotrexate and are given by pill. Arava is roughly comparable to Methotrexate but newer and is given by pill. God bless.

----- Original Message -----

From: StarsHutch@...

Rheumatoid Arthritis

Sent: Saturday, August 28, 2004 8:05 PM

Subject: Re: Re: What is gold treatment?

I have been taking Methotrexate for 2 months now and wasn't able to cut back on the Prednisone because of the pain. I am still taking 10 mg of Pred a day and am up to 6 MTX a week. I can't tell if the MTX is working at all. It doesn't seem like it.My next appointment with the rheumy is Sept 7th.How long can someone stay on Prednisone? Are the other DMARDs only dosed with a needle? Becky Glaser & Soul are the Real Starsky & Hutch! http://www.geocities.com/starskyhutch4evrhttp://www.geocities.com/glasersoulfargas2004/

[Guest guest]

In a message dated 8/29/2004 12:48:34 AM Central Standard Time, hvantuyl@... writes:

Most people give up on Methotrexate or any other DMARD after 3 or 4 months without appreciable improvement but I have read of a person who took it for a year before noticing improvement. Also you should count from the last increase in your dosage and not from the time the medicine was first started. Bu giving up I mean increasing the dosage, changing to a different medication, or adding another medication. Often a combination of two or more DMARDs works better than any one alone.

Thank you for the information! I have printed it out for future reference.

I have increased my calcium intake since starting the Prednisone.

Becky