We examined whether changes in auranofin dose regimen in rheumatoid arthritis (RA) patients affect cell-associated and/or serum gold levels. In 7 RA patients, a reduction in daily dosage of auranofin from 3 mg bid to 3 mg qd was correlated with a marked reduction (81%-95%) in cell-associated gold, whereas a return to the 3 mg bid dose level resulted in a reinstatement of cell-associated gold. These changes in cell-associated gold were not reflected in alterations of serum gold levels. This apparent lack of change in serum gold level as opposed to cell-associated gold suggests that this phenomenon warrants further investigation.