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Penicillamine in systemic sclerosis: a reappraisal
M A Sattar1, R T Guindi, T N Sugathan
1Department of Medicine, Faculty of Medicine, Kuwait University.
Clinical Rheumatology
|December 1, 1990
Summary
D-penicillamine treatment improved diffuse systemic sclerosis skin involvement in a 36-month trial. Early, low-dose D-penicillamine therapy showed benefits without side effects for systemic sclerosis patients.
Area of Science:
- Rheumatology
- Dermatology
- Pharmacology
Background:
- Systemic sclerosis is a chronic autoimmune disease characterized by fibrosis.
- D-penicillamine is a chelating agent with immunomodulatory properties.
- Treatment options for systemic sclerosis, particularly early-stage, require further investigation.
Purpose of the Study:
- To evaluate the efficacy and safety of prolonged low-dose D-penicillamine treatment in patients with systemic sclerosis.
- To assess the impact of D-penicillamine on skin involvement and systemic progression in different subtypes of systemic sclerosis.
Main Methods:
- A 36-month prospective trial involving 21 patients with systemic sclerosis (16 diffuse, 5 limited cutaneous).
- Patients received D-penicillamine treatment.
- Objective improvements in skin involvement and systemic progression were monitored.
Main Results:
- Significant objective improvement in skin involvement was observed in all patients with diffuse systemic sclerosis (p < 0.001).
- No objective improvement was noted in patients with the limited cutaneous subtype.
- No systemic progression of the disease was observed during the study period in any patient.
Conclusions:
- Prolonged, low-dose D-penicillamine treatment is beneficial and effective for diffuse systemic sclerosis, especially when initiated early.
- D-penicillamine appears to be safe and free of side effects when used in the early stages of systemic sclerosis.
- The drug showed no efficacy in the limited cutaneous subtype of systemic sclerosis.