Synthetic D(-)penicillamine in rheumatoid arthritis. Double-blind controlled study of a high and low dosage regimen

• Published in: Annals of the rheumatic diseases 1975-10, Vol.34 (5), p.416-421
• Main Authors: Dixon, A J, Davies, J, Dormandy, T L, Hamilton, E B, Holt, P J, Mason, R M, Thompson, M, Weber, J C, Zutshi, D W
• Format: Article
• Language: English
• Subjects: Acetaminophen - therapeutic use; Arthritis, Rheumatoid - drug therapy; Arthritis, Rheumatoid - physiopathology; Aspirin - therapeutic use; Clinical Trials as Topic; Dyspepsia - chemically induced; Female; Humans; Male; Movement; Nausea - chemically induced; Penicillamine - administration & dosage; Penicillamine - adverse effects; Penicillamine - therapeutic use; Pruritus - chemically induced; Taste Disorders - chemically induced; Vomiting - chemically induced
• ISSN: 0003-4967; 1468-2060
• DOI: 10.1136/ard.34.5.416

Doses of 600 mg and 1200 mg of D(-)penicillamine daily were superior to a standard regimen of therapy in rheumatoid arthritis. The higher dose did not produce significantly greater therapeutic benefit in the group of patients so treated, although individual patients sometimes improved more. The frequency of rashes, blood dyscrasias, and withdrawals from the trial increased withe dosage. It is concluded that D(-)penicillamine is a useful treatment that the daily dose should be as low as possible, and that it should be increased at infrequent intervals only, with due regard to the likelihood of further improvement in relation to an increased risk of adverse reactions.