Auranofin

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Auranofin
Clinical data
Trade namesRidaura
AHFS/Drugs.comConsumer Drug Information
MedlinePlusa685038
Pregnancy
category
  • AU: B3
Routes of
administration		Oral
ATC code
Legal status
Legal status
  • AU: S4 (Prescription only)
  • UK: POM (Prescription only)
  • US: WARNING[1]Rx-only
Pharmacokinetic data
Bioavailability40%[2][3]
Protein binding60%[2][3]
MetabolismPlasma membrane of the cell removes the acetyl groups of the glucose moiety.
Elimination half-life21-31 days[2][3]
ExcretionUrine (60%), faeces[2][3]
Identifiers
  • Gold(+1) cation; 3,4,5-triacetyloxy-6- (acetyloxymethyl) oxane-2-thiolate; triethylphosphanium
JSmol)
  • CCP(=[Au]S[C@H]1[C@@H]([C@H]([C@@H]([C@H](O1)COC(=O)C)OC(=O)C)OC(=O)C)OC(=O)C)(CC)CC
  • InChI=1S/C14H20O9S.C6H15P.Au/c1-6(15)19-5-10-11(20-7(2)16)12(21-8(3)17)13(14(24)23-10)22-9(4)18;1-4-7(5-2)6-3;/h10-14,24H,5H2,1-4H3;4-6H2,1-3H3;/q;;+1/p-1/t10-,11-,12+,13-,14+;;/m1../s1 checkY
  • Key:AUJRCFUBUPVWSZ-XTZHGVARSA-M checkY
 ☒NcheckY (what is this?)  (verify)

Auranofin is a

antirheumatic agent
. It has the brand name Ridaura.

Use

Auranofin is used to treat

gold thioglucose), but meta-analysis of 66 clinical trials concluded that it is somewhat less effective.[5]

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 diarrhea, which can develop in the early months of treatment. The development of loose stools occurs in 40 % of patients, while watery diarrhea is reported in just 2–5 % of patients, and in most cases these symptoms were alleviated by reducing or splitting the dose".[6]

Research

HIV infection

Auranofin is under investigation as a means of reducing the viral reservoir of

antiretroviral therapy.[7] The drug was shown to reduce the amount of latent virus in monkey trials.[8] A human study testing auranofin and other investigational treatments is ongoing in Brazil.[9] Preliminary results show that auranofin contributed to a decrease in the viral reservoir.[10]

Amebiasis

Auranofin has been identified in a high-throughput drug screen as 10 times more potent than

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.[11][12][13]

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.[14][15]

Tuberculosis

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.[16]

Ovarian cancer

Drug-screening reveals auranofin induces apoptosis in ovarian cancer cells in vitro.[17][18]

Lung cancer including Adenocarcinoma

When mice with Protein kinase Cι (PKCι)–dependent KP adenocarcinoma tumors that exhibited resistance to anti–PD-1 antibody therapy (α-PD-1) were treated with auranofin, the PKCι inhibitor auranofin inhibited KP tumor growth and sensitized these tumors to α-PD-1. [19] The Mayo clinic is running a clinical trial to research the effects of auranofin and sirolimus on squamous, ras mutated lung adenocarcinoma, and small cell lung cancer. [20]

COVID-19

Auranofin may inhibit replication of SARS-CoV-2, the virus responsible for causing COVID-19 in cell culture. Inflammation may also be reduced.[21]

Etymology

The brand name Ridaura was coined from the phrase Remission-Inducing Drug + Auranofin. [22]

References

  1. FDA
    . Retrieved 22 Oct 2023.
  2. ^
    PMID 9189058
    .
  3. ^ a b c d "Ridaura (auranofin) dosing, indications, interactions, adverse effects, and more". Medscape Reference. WebMD. Retrieved 13 March 2014.
  4. ^ MedlinePlus DrugInfo medmaster-a685038
  5. PMID 1977391
    .
  6. PMID 25698589
    .
  7. ^ Gold-based drug shows promise in clearing HIV reservoir in monkey study. Keith Alcorn. AIDSmaps.com. Accessed 23 April 2011.
  8. S2CID 19698337
    .
  9. ^ "Multi Interventional Study Exploring HIV-1 Residual Replication: a Step Towards HIV-1 Eradication and Sterilizing Cure - Full Text View - ClinicalTrials.gov". Retrieved 2018-08-14.
  10. ^ "Auranofin plus nicotinamide impact HIV reservoir among ART suppressed HIV individuals" (MS Power Point). Retrieved 2018-08-16.
  11. PMID 22610278
    .
  12. ^ "Drug Found for Parasite That Is Major Cause of Death Worldwide". Science Daily.
  13. ^ "Arthritis Drug Effective Against Global Parasite, Study Suggests". Science Daily.
  14. S2CID 237267846
    .
  15. S2CID 54468504
    .
  16. PMID 25831516
    .
  17. PMID 25096914
    .
  18. PMID 26731315
    .
  19. S2CID 253554150
    .
  20. ^ "PKCι & mTOR Inhibition With Auranofin+Sirolimus for Squamous Cell Lung Cancer". Retrieved 2023-02-13.
  21. ^ "Georgia State Researchers Find Rheumatoid Arthritis Drug Is Effective Against Coronavirus". News Hub. 15 April 2020. Retrieved 15 April 2020.
  22. ISBN 978-2760519510
    – via Google Books.

Further reading

External links
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