Stimulation of urinary copper excretion by trientine((R)) in nickel-sensitive patients

Trientine((R)) is not an effective drug for the treatment of intractable hand dermatitis in nickel-sensitive patients. In a controlled, double-blind study this chelator, on oral administration, failed to stimulate nickel excretion. Early morning urine samples from two groups of nine patients were analyzed by atomic absorption spectrophotometry in a stabilized Temperature Platform Furnace equipped with Zeeman background correction. Group 1 patients received placebo for 6 wk, then a 4-wk rest before crossover. Group 2 received the drug in the first period. No difference in Ni levels between the placebo period and the drug period in either group was demonstrated, nor was there any significant improvement in the hand eczema.Copper was measured in the same urine samples using the same instrumentation, but with atomization off the wall. There was a considerable increase in copper excretion during the drug treatment period. Group 1 excreted a mean 538±378 (SD) μg/L, which represented a mean increase of 787±653 % (SD). Group 2 excreted a mean 960±410 (SD) μg/L; a mean difference of 630±398 % (SD). It was concluded that the use of Trientine((R)) in subjects of normal copper status should be carefully controlled and monitored.