Adverse effects of D-penicillamine in rheumatoid arthritis.

Abstract:

:Adverse effects to D-penicillamine were studied prospectively over 3 years in 259 patients with rheumatoid arthritis. Ninety-five percent had had gold therapy previously, yet 70% benefited from D-penicillamine therapy. Of the 275 courses given, 160 (58%) were complicated by at least one reaction, including rashes (44%), dysgeusia (20%), gastrointestinal upset (18%), stomatitis (10%), proteinuria (7%), thrombocytopenia (3%), and leukopenia (2%). Their occurrences peaked in the first 6 months of treatment, except for proteinuria and thrombocytopenia, which peaked in the second 6 months. Reactions were commoner at daily doses above 250 mg; mean daily doses for proteinuria, thrombocytopenia, and leukopenia were higher (approximately 600 mg/d) than for the others (approximately 500 mg/d). Of 114 discontinued courses, 73 (27%) were due to adverse reactions. The remaining reactions were controlled by altering dosages and symptomatic treatment. Only obliterative bronchiolitis (two cases) was irreversible; it resulted in the only death in our series, possibly attributable to penicillamine.

journal_name

Ann Intern Med

authors

Stein HB,Patterson AC,Offer RC,Atkins CJ,Teufel A,Robinson HS

doi

10.7326/0003-4819-92-1-24

subject

Has Abstract

pub_date

1980-01-01 00:00:00

pages

24-9

issue

1

eissn

0003-4819

issn

1539-3704

journal_volume

92

pub_type

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