Side Effects of auranofin: A Synthesis of Findings from 23 Studies

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Original Abstract of the Article

Major Research Findings

Auranofin is a gold-containing compound that has been used to treat rheumatoid arthritis, and it has recently shown promise as an anticancer agent. Studies have shown that auranofin can effectively inhibit the growth of cancer cells, particularly in cases of acute lymphoblastic leukemia. 5 Its mechanism of action involves disrupting the balance of reactive oxygen species within cancer cells, leading to their destruction. 5

The research on auranofin has also focused on its ability to target specific cells, which is essential for reducing side effects. Researchers have been developing ways to deliver auranofin specifically to cancer cells, thereby minimizing damage to healthy cells. 4

Several studies have investigated the effectiveness of auranofin in treating various diseases. For example, a study on desmoid-type fibromatosis (DF) found that auranofin effectively inhibits the progression of this condition, making it a potential treatment option. 3

Reasons for Side Effects

The side effects of auranofin are often attributed to its interaction with the thioredoxin reductase (TrxR) system, an essential component of the antioxidant defense system in many cells. 13 Auranofin's inhibition of TrxR can lead to an imbalance in reactive oxygen species, causing oxidative stress and cell death. 13 Additionally, auranofin can disrupt intracellular calcium homeostasis, leading to platelet necrosis and other undesirable effects. 13

Common Side Effects

Diarrhea

Auranofin is known to cause gastrointestinal side effects, including diarrhea. This effect can be particularly prominent in the early stages of treatment but tends to lessen over time. 1 The incidence of diarrhea can be as high as 50% in patients starting auranofin treatment. 1

Thrombocytopenia

One of the significant side effects of auranofin is a decrease in platelet count, also known as thrombocytopenia. This reduction in platelets can increase the risk of bleeding. 13 This side effect is associated with auranofin's disruption of intracellular calcium homeostasis and its potential to cause platelet necrosis. 13

Cardiotoxicity

While auranofin is generally well-tolerated, some studies have reported potential cardiotoxicity, particularly at higher doses or with prolonged use. 11 Further research is needed to fully understand the cardiovascular implications of auranofin treatment.

Skin Reactions

Auranofin can sometimes cause allergic reactions in the skin, manifesting as rash or itching. 20 This is more common in patients with a pre-existing allergy to gold. 20

Countermeasures for Side Effects

Diarrhea

For patients experiencing diarrhea, it is crucial to stay hydrated and consider antidiarrheal medications if necessary. 1

Thrombocytopenia

Regular blood tests are essential to monitor platelet count during auranofin treatment. If thrombocytopenia develops, auranofin dosage may need to be adjusted or discontinued. 13

Cardiotoxicity

Regular cardiac monitoring is recommended during auranofin treatment, especially with higher doses or prolonged use. If any cardiovascular abnormalities arise, the treatment plan needs to be reassessed. 11

Skin Reactions

If skin reactions occur, it is essential to contact a healthcare professional. The treatment may need to be adjusted, or alternative medications may be considered. 20

Comparison of Research

Commonalities in Research

Most studies agree that auranofin can be effective in treating various conditions, including rheumatoid arthritis and certain types of cancer. Auranofin has also been consistently linked to side effects such as diarrhea and thrombocytopenia.

Differences in Research

The research on auranofin's cardiotoxicity is somewhat inconsistent. Some studies have suggested a potential for cardiotoxicity, while others have not observed this effect. 11 Further research is necessary to better understand the cardiovascular implications of auranofin.

Points to Note Regarding Application in Real Life

Auranofin is a powerful medication that should only be used under the supervision of a healthcare professional. It is essential to inform your doctor about any pre-existing health conditions or allergies, particularly to gold. It is crucial to avoid self-medication and to report any side effects promptly to your doctor.

Limitations of Current Research

While auranofin shows promise in treating various conditions, further research is needed to fully understand its long-term effects and potential side effects. The cardiotoxicity of auranofin requires further investigation to determine its prevalence and severity.

Future Research Directions

Future research should aim to develop safer and more targeted delivery methods for auranofin, potentially minimizing side effects and maximizing therapeutic efficacy. Further investigation into auranofin's cardiotoxicity and its long-term effects is crucial for ensuring its safe and effective use.

Conclusion

Auranofin is a promising therapeutic agent with potential for treating rheumatoid arthritis, certain cancers, and other conditions. However, it is important to be aware of its side effects, including diarrhea, thrombocytopenia, and potential cardiotoxicity. Close monitoring and communication with your doctor are essential when using auranofin.

Literature analysis of 23 papers
Positive Content
19
Neutral Content
0
Negative Content
4
Article Type
2
0
0
6
23
1.

The moderate intestinal side effects of auranofin do not require prophylactic therapy with a bulkforming agent. Dutch Ridaura Study Group.

Author: van BeusekomH J, van de LaarM A, FranssenM J, van ValburgJ A, GijzelW P, CouvéeJ E

Auranofin treatment
Diarrhea
Loose stools

Auranofin, a drug used to treat rheumatoid arthritis, can cause diarrhea and loose stools in up to 50% of patients. This study investigated whether a bulk-forming agent could reduce these side effects. While a slight improvement in stool consistency was observed in the bulk-forming group, the overall incidence of diarrhea remained similar to the placebo group. The results suggest that a bulk-forming agent is not beneficial in reducing auranofin-induced diarrhea, and that increasing the auranofin dosage might be a better option to enhance its efficacy.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

2.

Mechanism of action, pharmacology, clinical efficacy and side effects of auranofin. An orally administered organic gold compound for the treatment of rheumatoid arthritis.

Author: FurstD E

Favorable therapeutic index
Rheumatoid arthritis treatment
Side effects

Auranofin, an oral gold compound, is effective in treating rheumatoid arthritis. It is generally less toxic than intramuscular gold compounds.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

3.

Efficacy of auranofin as an inhibitor of desmoid progression.

Author: ItoKan, NishidaYoshihiro, HamadaShunsuke, ShimizuKoki, SakaiTomohisa, OhkawaraBisei, AlmanBenjamin A, EnomotoAtsushi, IkutaKunihiro, KoikeHiroshi, ZhangJiarui, OhnoKinji, ImagamaShiro

Effective DF treatment
Fewer side effects

Auranofin, an FDA-approved anti-rheumatic drug, was identified as a potential treatment for desmoid-type fibromatosis (DF). The drug effectively inhibited the proliferation of DF cells and reduced tumor development in a mouse model.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

5.

Exploiting the reactive oxygen species imbalance in high-risk paediatric acute lymphoblastic leukaemia through auranofin.

Author: KarsaMawar, KosciolekAngelika, BongersAngelika, MarianaAnna, FailesTim, GiffordAndrew J, KeesUrsula R, CheungLaurence C, KotechaRishi S, ArndtGreg M, HaberMichelle, NorrisMurray D, SuttonRosemary, LockRichard B, HendersonMichelle J, SomersKlaartje

Selective cytotoxicity
Well tolerated

Auranofin is a well-tolerated drug candidate for high-risk paediatric leukaemias that warrants further preclinical investigation for application in high-risk paediatric and adult acute leukaemias.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Mechanistic Insights Into the Anticancer Properties of the Auranofin Analog Au(PEt<sub>3</sub>)I: A Theoretical and Experimental Study.

Author: TolbatovIogann, CirriDamiano, MarchettiLorella, MarroneAlessandro, ColettiCecilia, ReNazzareno, La MendolaDiego, MessoriLuigi, MarzoTiziano, GabbianiChiara, PratesiAlessandro

Antitumor activity

Replacing the thiosugar moiety in auranofin with iodide in Au(PEt<sub>3</sub>)I significantly enhances its antitumor activity, particularly against ovarian and colorectal cancers. This enhancement is attributed to the increased reactivity of Au(PEt<sub>3</sub>)I towards amino acid residues like histidine, cysteine, methionine, and selenocysteine.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

8.

Rhenium-Based Complexes and in Vivo Testing: A Brief History.

Author: CapperMiles S, PackmanHollie, RehkämperMark

Cancer treatment
Drug resistance
Toxic side effects

Metal-based anticancer drugs have a major role in cancer therapy, with cisplatin being a key example. This review focuses on rhenium-based complexes, a promising class of metal-based drugs that are currently undergoing in vivo testing. Nine rhenium-based drug candidates have shown antitumour activity in vivo, and further research is needed to evaluate their potential for clinical trials.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

9.

Sugar-Modified Analogs of Auranofin Are Potent Inhibitors of the Gastric Pathogen <i>Helicobacter pylori</i>.

Author: EpsteinTessa D, WuBin, MoultonKaren D, YanMingdi, DubeDanielle H

Treat H. pylori infection
Mammalian cell toxicity

Sugar-modified analogs of auranofin, a drug currently used for rheumatoid arthritis, have shown promising results as potential antibiotics against *H. pylori* infection. These analogs exhibited micromolar minimum inhibitory concentrations against *H. pylori* and caused reduced toxicity to mammalian cells.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, N.I.H., ExtramuralResearch funding provided by the NIH to external research institutions and researchers.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

10.

Auranofin/Vitamin C: A Novel Drug Combination Targeting Triple-Negative Breast Cancer.

Author: HatemElie, AzziSandy, El BannaNadine, HeTiantian, Heneman-MasurelAmélie, VernisLaurence, BaïlleDorothée, MassonVanessa, DingliFlorent, LoewDamarys, AzzaroneBruno, EidPierre, BaldacciGiuseppe, HuangMeng-Er

Cancer cell killing
Redox-based therapy

This article discusses the complex interplay between redox status and anticancer therapy. Cancer cells exhibit varying basal redox statuses and respond differently to oxidative stress, impacting the efficacy of redox-based anticancer therapies.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

12.

Auranofin/Vitamin C: A Novel Drug Combination Targeting Triple-Negative Breast Cancer.

Author: HatemElie, AzziSandy, El BannaNadine, HeTiantian, Heneman-MasurelAmélie, VernisLaurence, BaïlleDorothée, MassonVanessa, DingliFlorent, LoewDamarys, AzzaroneBruno, EidPierre, BaldacciGiuseppe, HuangMeng-Er

Cancer cell killing

This article discusses the role of reactive oxygen species (ROS) in redox-based anticancer therapies, emphasizing the importance of understanding the varying basal redox statuses of cancer cells from different origins.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

15.

New drug target in protozoan parasites: the role of thioredoxin reductase.

Author: AndradeRosa M, ReedSharon L

Amebiasis treatment

Amebiasis is a parasitic disease that causes 70,000 deaths each year. This study found that auranofin, a drug originally approved to treat rheumatoid arthritis, was effective against the parasite that causes amebiasis. This could be a new treatment option for this disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

16.

Enhanced eryptosis following auranofin exposure.

Author: AlzoubiKousi, EglerJasmin, AbedMajed, LangFlorian

Anticancer
Antiinflammatory
Antimicrobial
Anemia

Auranofin is an antiinflammatory, antimicrobial and anticancer drug known to trigger apoptosis. Side effects of the drug include anaemia, which may result from stimulation of suicidal death of erythrocytes or eryptosis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

18.

A new concept: the use of vanadium complexes in the treatment of diabetes mellitus.

Author: SakuraiHiromu

DM treatment
Prevents DM

Vanadium compounds showed promising results as potential treatments for diabetes mellitus, offering a new class of drugs with insulin-mimetic effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

20.

Contact allergy to gold and gold therapy in patients with rheumatoid arthritis.

Author: MöllerH, SvenssonA, BjörknerB, BruzeM, LindrothY, ManthorpeR, TheanderJ

Gold allergy

Contact allergy to gold is common among patients with rheumatoid arthritis before gold therapy, highlighting the need for skin tests to prevent hypersensitivity reactions.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

21.

Mechanisms of drug-induced diarrhoea in the elderly.

Author: RatnaikeR N, JonesT E

Dehydration
Drug-induced diarrhea
Electrolyte imbalance
Undernutrition

Diarrhea as a result of drug therapy is an important consideration in the elderly population. Drugs can compromise both immune and nonimmune responses, and may cause diarrhea by interfering with normal physiological processes, by mucosal damage, or by osmotic effects.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
ReviewAn article that critically examines existing research on a particular topic and summarizes the current state of knowledge in the field.

Language : English

22.

[Comparative study of the effects of auranofin and aurothiomalate on laboratory and clinical indicators in patients with rheumatoid arthritis].

Author: VlakT, StambukB

RA Treatment

Auranofin (oral) and aurothiomalate (intramuscular) showed similar effects and tolerability in patients with rheumatoid arthritis. Both treatments significantly improved disease parameters, but aurothiomalate was better tolerated.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Controlled Clinical TrialA clinical trial that evaluates the effectiveness of a treatment by comparing a group that receives the intervention with a group that receives a placebo or standard treatment.
English AbstractA summary of a research paper/publication written in English for a wider audience.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : Croatian

23.

Does sulphasalazine cause drug induced systemic lupus erythematosus? No effect evident in a prospective randomised trial of 200 rheumatoid patients treated with sulphasalazine or auranofin over five years.

Author: GordonM M, PorterD R, CapellH A

Leucopenia
Mouth ulcers
Rash

This study found that antinuclear antibody (ANA) positivity was common in patients with rheumatoid arthritis, but did not increase the likelihood of withdrawing from treatment or developing drug-induced systemic lupus erythematosus (SLE).

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Randomized Controlled TrialA clinical trial that randomly assigns participants to treatment and control groups to evaluate the effects of an intervention.

Language : English

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