Auranofin
| Evidence Level: L5 | Predicted Indications: 2 |
Table of Contents
- Auranofin
- Pharmacist Assessment Report
- Auranofin: From Rheumatoid Arthritis to Colobomatous Microphthalmia-Rhizomelic Dysplasia Syndrome
- One-Sentence Summary
- Quick Overview
- Why is This Prediction Reasonable?
- Clinical Trial Evidence
- Literature Evidence
- Canada Market Information
- Safety Considerations
- Conclusion and Next Steps
- Disclaimer
Auranofin: From Rheumatoid Arthritis to Colobomatous Microphthalmia-Rhizomelic Dysplasia Syndrome
One-Sentence Summary
Auranofin is a gold-based medicine originally used to treat rheumatoid arthritis. The TxGNN model predicts it may be effective for colobomatous microphthalmia-rhizomelic dysplasia syndrome, a rare congenital disorder. This prediction currently has no clinical trials and no publications behind it; it rests on the model score alone.
Quick Overview
| Item | Content |
|---|---|
| Original Indication | Rheumatoid arthritis |
| Predicted New Indication | Colobomatous microphthalmia-rhizomelic dysplasia syndrome |
| TxGNN Prediction Score | 0.9956 |
| Evidence Level | L5 |
| Canada Market Status | Marketed (marketed DINs: 1 of 1) |
| Number of DINs | 1 (marketed: 1) |
| Recommended Decision | Hold |
Why is This Prediction Reasonable?
Currently, detailed mechanism of action data is not available in the data compiled for this report. Auranofin is a gold-containing drug whose efficacy in rheumatoid arthritis is established. In general terms it is known to modulate inflammatory pathways, but this is not supported by the data compiled here.
No mechanistic link to the predicted condition could be established. The only support is the high TxGNN TxGNN model (deep learning) score (0.9956). The predicted disease is a rare congenital disorder with eye and skeletal malformations. It is very different from an adult inflammatory joint disease, and no pharmacological reason is apparent for an anti-rheumatic drug to help with a developmental condition.
A second prediction, brachydactyly-syndactyly syndrome (score 0.9924), also has no trials, no publications and no mechanistic rationale. Both predictions should be treated as hypothesis-generating signals only.
Clinical Trial Evidence
Currently no related clinical trials registered.
Literature Evidence
Currently no related literature available.
Canada Market Information
| DIN | Product Name | Dosage Form | Approved Indication |
|---|---|---|---|
| 01916823 | RIDAURA | Not listed | Not listed |
Safety Considerations
Contraindication-related conditions (from the TxGNN knowledge graph, not from label text): The knowledge graph links auranofin with the following conditions as contraindications. They should be checked against the official label.
- Blood disorders: hematologic disease, thrombocytopenia, neutropenia, agranulocytosis, leukopenia
- Kidney and liver: kidney disease, liver disease, hepatitis, gallbladder disease
- Skin and allergy: exanthem, exfoliative dermatitis, urticaria, angioedema, atopic eczema, dermatitis
- Lung: pulmonary fibrosis, postinflammatory pulmonary fibrosis
- Gut: colitis, necrotizing enterocolitis, pyoureter
- Metabolic and cardiovascular: diabetes mellitus, diabetic ketoacidosis, hypertension, hypertensive disorder
- Autoimmune and other: systemic lupus erythematosus (including pediatric), Sjogren syndrome, dry eye syndrome
Drug Interactions: 86 potential interactions were identified. Examples from the list reviewed:
- Major: Deferiprone, Proguanil, Chloroquine
- Moderate: Metronidazole, Tinidazole, Benznidazole, Rosuvastatin, Simvastatin, Disulfiram
- Unknown severity: Warfarin, Prednisone, Prednisolone, Omeprazole, Pantoprazole, Lansoprazole, Ranitidine, Misoprostol, Clarithromycin, Calcitriol, Folic acid
The Health Canada package insert warnings were not available for this report. Please refer to the package insert for the official safety information.
Conclusion and Next Steps
Decision: Hold
Rationale: The prediction is supported only by a model score, with no clinical trials, no literature and no identifiable mechanism. The disease is a congenital malformation syndrome, which makes a benefit from an anti-rheumatic drug biologically unlikely. The knowledge graph also lists many contraindicated conditions, including serious blood, kidney and liver disorders.
To proceed, the following is needed:
- Mechanism of action data for auranofin (for example from DrugBank)
- The Health Canada package insert, with its warnings and contraindications, to allow safety screening
- A biological rationale linking auranofin to the genetic or developmental pathways of the predicted disease
- Preclinical or mechanistic studies, since no human evidence currently exists
- A review of whether a drug with this safety profile is suitable for the rare, likely paediatric population affected
Disclaimer
This content is for research purposes only and does not constitute medical advice. Clinical validation is required before any clinical application.