Comparison of pyritinol and auranofin in the treatment of rheumatoid arthritis.

Lemmel EM.

Staatliches Rheumakrankenhaus
Baden-Baden, Germany.
Br J Rheumatol 1993 May;32(5):375-82

ABSTRACT

The efficacy and tolerability of pyritinol and auranofin (AU) were compared in a multicentre double-blind study.  Patients with RA received 600 mg/day pyritinol or 6 mg/day AU for 1 year.  Response was rated by a defined improvement in at least four of the following:  Ritchie index, joint swelling index, rating scales for pain and general well-being, functional index, morning stiffness, ESR.  Of the 139 fully evaluable pyritinol patients 61 (44%) dropped out due to adverse events or response failure compared with 44 (31%) of the 142 AU patients. In patients treated for 1 year efficacy parameters improved more in the pyritinol than in the AU group, with significant differences for the general well-being (P = 0.022), ESR (P = 0.029) and haemoglobin (P = 0.0042).  The response rate for pyritinol (61/78 patients, 78%) was significantly superior to AU (58/98 patients, 59% P = 0.009).  An intention-to-treat analysis corroborated this result (P = 0.030).  Adverse events (AE) occurred in 64% of pyritinol patients and in 58% of AU patients: main AE were mucocutaneous symptoms (pyritinol 36%, AU 23%) and gastrointestinal complaints (pyritinol 30% AU 37%).  Single cases of proteinuria, hepatic and haematological abnormalities were noted in both groups