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Penicillamine therapy in systemic sclerosis.

M I Jayson1, C Lovell, C M Black

  • 1University of Bristol Department of Medicine.

Proceedings of the Royal Society of Medicine
|January 1, 1977
PubMed
Summary
This summary is machine-generated.

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D-penicillamine offers limited benefit for skin symptoms in progressive systemic sclerosis. It shows little to no value for vascular and visceral complications, with significant side effects in some patients.

Area of Science:

  • Rheumatology
  • Dermatology
  • Pharmacology

Background:

  • Progressive systemic sclerosis (PSS) is a serious autoimmune disease.
  • Effective treatments for PSS, particularly for its systemic manifestations, remain a challenge.

Purpose of the Study:

  • To evaluate the efficacy and safety of D-penicillamine in patients with progressive systemic sclerosis.
  • To assess the impact of D-penicillamine on cutaneous, joint, vascular, and visceral features of PSS.

Main Methods:

  • A cohort of twenty-two patients with PSS received D-penicillamine.
  • Dosages varied up to 1250 mg/day, with treatment durations from months to four years.
  • Adverse events, clinical benefits, and disease progression were monitored.

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Main Results:

  • Fifteen patients experienced cutaneous benefits, but only 5 achieved overall good results due to side effects, relapses, or disease progression.
  • Joint function improved in 7 patients, with only 3 showing good overall results.
  • D-penicillamine did not influence peripheral vascular disease or visceral involvement; these sometimes worsened during treatment.
  • Seven patients died due to visceral manifestations of PSS.

Conclusions:

  • D-penicillamine has limited efficacy for the cutaneous manifestations of progressive systemic sclerosis.
  • The drug appears to be of no significant value for the vascular and visceral complications of PSS.
  • Treatment with D-penicillamine is associated with notable side effects and limited overall clinical benefit in PSS.