An open study in Belgium assessed the clinical efficacy and safety of auranofin (AF) in treating psoriatic arthritis. The study enrolled 29 patients; median age was 46 years and median duration of disease was 5.5 years. Patients received 6 mg AF daily, given as two 3-mg tablets once a day. Concomitant therapy with nonsteroidal anti-inflammatory drugs (NSAIDs) and corticosteroids was permitted. Efficacy of auranofin was apparent by 3 months after the start of treatment, as evidenced by improvement over baseline in number of tender joints, severity of pain, and erythrocyte sedimentation rate. After 1 year of auranofin therapy there was 50% or greater improvement over baseline in these parameters in 11% to 41% of the total population, and in 19% to 69% of those who completed at least 1 year of treatment. Diarrhea was reported in 45% of patients, occurring most often during the first 6 months of therapy. Nausea occurred in 10%; abdominal pain in 7%; rash in 14%; and pruritus in 17%. Withdrawals because of adverse events totaled 4: 1 for rash, 2 for pruritus, and 1 for rash, pruritus, and purpura. Auranofin may be considered an effective and safe therapeutic alternative for the treatment of psoriatic arthritis.