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Related Experiment Videos

D-penicillamine for primary sclerosing cholangitis.

S L Klingenberg1, W Chen

  • 1Copenhagen Trial Unit, Centre for Clinical Intervention Research, Cochrane Hepato-Biliary Group, Department 7102, H:S Rigshospitalet, Copenhagen University Hospital, Blegdamsvej 9, DK-2100 Copenhagen, Denmark. slk@ctu.rh.dk

The Cochrane Database of Systematic Reviews
|January 27, 2006
PubMed
Summary

D-penicillamine showed no significant benefit for primary sclerosing cholangitis (PSC) patients, despite improving one liver enzyme. The treatment led to more adverse events, and evidence is insufficient to recommend its use.

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Area of Science:

  • Hepatology and Gastroenterology
  • Clinical Pharmacology

Background:

  • Primary sclerosing cholangitis (PSC) is a chronic cholestatic liver disease.
  • D-penicillamine is investigated for PSC due to its copper-reducing and immunomodulatory properties.

Purpose of the Study:

  • To assess the efficacy and safety of D-penicillamine in treating primary sclerosing cholangitis.
  • Evaluate beneficial and harmful effects of D-penicillamine for PSC patients.

Main Methods:

  • Systematic review of randomized clinical trials comparing D-penicillamine with placebo or other interventions.
  • Searches included major databases (Cochrane, MEDLINE, EMBASE) up to August 2005.
  • One low-quality randomized trial with 70 PSC patients was included.

Main Results:

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  • D-penicillamine did not significantly impact mortality, liver transplantation, histologic progression, or cholangiographic deterioration.
  • A significant improvement in serum aspartate aminotransferase was observed, but not in bilirubin or alkaline phosphatase levels.
  • Adverse events were significantly more frequent in the D-penicillamine group (P=0.013).

Conclusions:

  • Insufficient evidence exists to support or refute D-penicillamine use in primary sclerosing cholangitis.
  • D-penicillamine is not recommended for PSC patients outside of controlled clinical trials.