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Adverse Events with D-penicillamine Therapy in Hepatic Wilson's Disease: A Single-Center Retrospective Audit

Sanjay Kumar1, Biswa Ranjan Patra1, Mohammed Irtaza1

  • 1Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Gastroenterology office, 9th floor, New Building, Parel, Mumbai, 400012, India.

Clinical Drug Investigation
|February 1, 2022
PubMed

Insights

D-penicillamine causes adverse events in 25% of Wilson

Area of Science:

  • Hepatology
  • Pharmacology
  • Clinical Medicine

Background:

  • Limited data exist on D-penicillamine adverse events in Wilson's disease (WD).
  • Hepatic WD patients often require dose modification or treatment cessation due to adverse events.
  • Understanding these adverse events is crucial for effective WD management.

Purpose of the Study:

  • To investigate the adverse events associated with D-penicillamine in patients with hepatic Wilson's disease.
  • To analyze the incidence, nature, and management of D-penicillamine-related adverse events.
  • To identify factors influencing treatment discontinuation and reintroduction strategies.

Main Methods:

  • Retrospective audit of prospectively registered hepatic WD patients (December 2006 - January 2020).
  • Analysis of demographic variables, laboratory parameters, and treatment details.
  • Detailed examination of D-penicillamine adverse events, their timing, and management strategies.

Main Results:

  • D-penicillamine intolerance occurred in 25% of 112 hepatic WD patients.
  • Hematological (57%) and renal (25%) adverse events were most common.
  • Temporary cessation with dose reintroduction was effective in 69% of cases, but 31% experienced recurrent adverse events.

Conclusions:

  • D-penicillamine treatment is linked to significant adverse events, primarily affecting blood, kidney, and skin.
  • Temporary drug cessation and reintroduction at a lower dose represent a safe and effective management approach.
  • Careful monitoring and individualized treatment adjustments are essential for managing D-penicillamine therapy in WD.

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