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Treatment of primary Sjögren's syndrome with D-penicillamine: a pilot study
E J ter Borg1, H C M Haanen, F J L M Haas
1Department of Rheumatology, Sint Antonius Hospital, Koekoekslaan 1, 3430 EM Nieuwegein, the Netherlands.
Background:
Up to now no satisfying systemic treatment is available for patients with primary Sjögren's syndrome.
Methods:
In a prospective, open study we investigated the effect of D-penicillamine (first three months 250 mg/day, next three months 500 mg/day) on clinical and immunological parameters in 19 patients with primary Sjögren's syndrome and a mean disease duration of 3.8 years.
Results:
Eight patients had to stop treatment mainly due to severe (reversible) loss of taste. Clinically, a statistically significant increase in basal salivary flow was observed after three months (p<0.05). In addition, improvement was noted in the Schirmer test and stimulated parotid salivary flow after six months, but these differences were not statistically significant. Laboratory values showed a decrease in ESR (p<0.05) and levels of IgA and IgM (both p<0.02) after six months, a decrease in levels of IgA-Rf and IgM-Rf after three months (both p<0.05), and an increase in haemoglobin level (p<0.05).
Conclusion:
From this pilot study we conclude that the treatment of primary Sjögren's syndrome with D-penicillamine has only marginal beneficial effects. Together with its clear side effects this means that D-penicillamine is unsuitable for this indication.
