|AHFS/Drugs.com||Consumer Drug Information|
|Metabolism||Plasma membrane of the cell removes the acetyl groups of the glucose moiety.|
|Elimination half-life||21-31 hours|
|Excretion||Urine (60%), faeces|
|CompTox Dashboard (EPA)|
|Chemical and physical data|
|Molar mass||678.48 g·mol−1|
|3D model (JSmol)|
|(what is this?)|
Auranofin is used to treat rheumatoid arthritis. It improves arthritis symptoms including painful or tender and swollen joints and morning stiffness. Auranofin is a safer treatment compared to the more common injectable gold thiolates (gold sodium thiomalate and gold thioglucose), but meta-analysis of 66 clinical trials concluded that it is somewhat less effective.
The drug was approved for the treatment of rheumatoid arthritis in 1985. No longer a first-line treatment for rheumatoid arthritis, due to "its adverse effects, most of which are associated with long-term use for chronic disease. The most common adverse effects are gastrointestinal complaints such as loose stools, abdominal cramping and watery diarrhoea, which can develop in the early months of treatment. The development of loose stools occurs in 40 % of patients, while watery diarrhoea is reported in just 2–5 % of patients, and in most cases these symptoms were alleviated by reducing or splitting the dose".
Auranofin is under investigation as a means of reducing the viral reservoir of HIV that lies latent in the body's T-cells despite treatment with antiretroviral therapy. The drug was shown to reduce the amount of latent virus in monkey trials. A human study testing auranofin and other investigational treatments is ongoing in Brazil. Preliminary results show that auranofin contributed to a decrease in the viral reservoir.
Auranofin has been identified in a high-throughput drug screen as 10 times more potent than metronidazole against Entamoeba histolytica, the protozoan agent of human amebiasis. Assays of thioredoxin reductase and transcriptional profiling suggest that the effect of auranofin on the enzyme enhances the sensitivity of the trophozoites to reactive oxygen-mediated killing in mouse and hamster models; the results are marked reductions of the number of parasites, the inflammatory reaction to the infestation, and the damage to the liver.
Acanthamoeba Keratitis and Primary Amoebic Meningoencephalitis
Auranofin may be useful in the prevention and control of Acanthamoeba infections, and in the treatment of primary amoebic meningoencephalitis, caused by pathogenic free-living amoebae Acanthamoeba spp and Naegleria fowleri, respectively.
In a cell-based screen, auranofin showed potent activity against replicating and non-replicating M. tuberculosis as well as other gram-positive bacteria. Auranofin protected mice from an otherwise lethal infection with methicillin-resistant S. aureus (MRSA). The drug acts in a similar manner in bacteria as in parasites by inhibiting thioredoxin reductase (TrxR). Studies in humans are needed to evaluate the potential of this drug to treat Gram-positive bacterial infections in humans.
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- "Ridaura (auranofin) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Retrieved 13 March 2014.
- MedlinePlus DrugInfo medmaster-a685038
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- Gold-based drug shows promise in clearing HIV reservoir in monkey study. Keith Alcorn. AIDSmaps.com. Accessed 23 April 2011.
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- Loufouma Mbouaka A, Leitsch D, Koehsler M, Walochnik J (August 2021). "Antimicrobial effect of auranofin against Acanthamoeba spp". International Journal of Antimicrobial Agents: 106425. doi:10.1016/j.ijantimicag.2021.106425. PMID 34419578.
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- Harbut MB, Vilchèze C, Luo X, Hensler ME, Guo H, Yang B, et al. (April 2015). "Auranofin exerts broad-spectrum bactericidal activities by targeting thiol-redox homeostasis". Proceedings of the National Academy of Sciences of the United States of America. 112 (14): 4453–8. Bibcode:2015PNAS..112.4453H. doi:10.1073/pnas.1504022112. PMC 4394260. PMID 25831516.
- Park SH, Lee JH, Berek JS, Hu MC (October 2014). "Auranofin displays anticancer activity against ovarian cancer cells through FOXO3 activation independent of p53". International Journal of Oncology. 45 (4): 1691–8. doi:10.3892/ijo.2014.2579. PMC 4151813. PMID 25096914.
- Oommen D, Yiannakis D, Jha AN (2016). "BRCA1 deficiency increases the sensitivity of ovarian cancer cells to auranofin". Mutation Research. 784–785: 8–15. doi:10.1016/j.mrfmmm.2015.11.002. PMID 26731315.
- "Georgia State Researchers Find Rheumatoid Arthritis Drug Is Effective Against Coronavirus". News Hub. 15 April 2020. Retrieved 15 April 2020.
- Jeon KI, Byun MS, Jue DM (April 2003). "Gold compound auranofin inhibits IkappaB kinase (IKK) by modifying Cys-179 of IKKbeta subunit". Experimental & Molecular Medicine. 35 (2): 61–6. doi:10.1038/emm.2003.9. PMID 12754408.
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- Rigobello MP, Folda A, Baldoin MC, Scutari G, Bindoli A (July 2005). "Effect of auranofin on the mitochondrial generation of hydrogen peroxide. Role of thioredoxin reductase". Free Radical Research. 39 (7): 687–95. doi:10.1080/10715760500135391. PMID 16036347. S2CID 9443834.
- Suarez-Almazor ME, Spooner CH, Belseck E, Shea B (2000). Suarez-Almazor ME (ed.). "Auranofin versus placebo in rheumatoid arthritis". The Cochrane Database of Systematic Reviews (2): CD002048. doi:10.1002/14651858.CD002048. PMC 8436883. PMID 10796461.