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Penicillamine in systemic sclerosis: A reappraisal

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Summary

In a 36-month prospective trial 21 patients with systemic sclerosis (diffuse systemic sclerosis 16 patients and 5 subjects with limited cutaneous subtype) were treated with D-penicillamine. In all patients with diffuse systemic sclerosis there was objective improvement. The degree and extent of skin involvement decreased significantly (p < 0.001), whereas no objective improvement was noted in patients with limited cutaneous subtype. Further, no systemic progression of the disease was observed during the study period. Our results suggest that a prolonged treatment with D-penicillamine in small doses is not only beneficial and effective but also free of side-effects, if used at an earlier stage.

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References

  1. Medsgar, T.A.Jr. Systemic sclerosis (Scleroderma), localised scleroderma, eosinophilic faciitis and calcinosis. Eds: Hollander, J., McCarty, D.J. In: Arthritis and Allied Conditions. 11th ed. pp. 1119–1165 Lea & Febiger, Philadelphia, 1989.

    Google Scholar 

  2. D'Angelo, W.A. Progressive systemic sclerosis: Management. Clin Rheum Dis 1979, 5, 263–77.

    Google Scholar 

  3. Medsger, T.A.Jr. Clinical trials in progressive systemic sclerosis. Clin Rheum Dis 1983, 9, 655–70.

    PubMed  Google Scholar 

  4. Steigerwald, J.C. Progressive systemic sclerosis: Management III Immunosuppressive agents. Clin Rheum Dis 1979, 5, 289–94.

    Google Scholar 

  5. Zarafonetis, C.J.D. Anti-fibrotic therapy with potaba. Am J Med Sci 1964, 248, 550–61.

    PubMed  Google Scholar 

  6. Alarcon-Segovia, D., Ramos-Niembro, F., Ibanez de Kasep, G., Alcocer, J., Parez Tamayo, R. Long evaluation of colchicine in the treatment of scleroderma. J Rheumatol 1979, 6, 705–712.

    PubMed  Google Scholar 

  7. Jaffe, I.A. Penicillamine. In: Arthritis and Allied Conditions. Ed: D.J. McCarty. 11th ed., Lea & Febiger, Philadelphia, 1989, pp. 593–603.

    Google Scholar 

  8. Harris, E.D., Sjoerdsma, A. Effects of penicillamine on human collagen and possible application to treatment of scleroderma. Lancet 1966, 2, 996–9.

    PubMed  Google Scholar 

  9. Medsger, T.A.Jr. Clinical trials in progressive systemic sclerosis. Clin Rheum Dis 1983, 9, 655–670.

    PubMed  Google Scholar 

  10. Rodnan, G.P. Progressive systemic sclerosis and D-pencillamine J Rheumatol 1981, 8, 116–120 (suppl. 7).

    Google Scholar 

  11. Steen, V.D., Medsgar, T.A.Jr., Rodnan, G.P. D-penicillamine therapy in progressive systemic sclerosis (scleroderma). A retrospective analysis. Ann Intern Med 1982, 97, 652–59.

    PubMed  Google Scholar 

  12. Medsger, T.A.Jr. Scleroderma: Recent advances in the treatment of progressive systemic sclerosis. Orthop Rev 1984, 13, 267–78.

    Google Scholar 

  13. Kang, B., Veres-Thorner, C., Heredia, R., Cha, E., Bore, S., Schwartz, M. Successful treatment of faradvances progressive systemic sclerosis by D-penicillamine. J Allergy Clin Immunol 1982, 69, 297–305.

    PubMed  Google Scholar 

  14. Shapiro, L.S., Prince, R.K., Buckingham, R.B., Rodnan, G.P. D-penicillamine treatment of progressive systemic sclerosis (scleroderma): A comparison of clinical and in vitro effects. J Rheumatol 1983, 10, 316–22.

    PubMed  Google Scholar 

  15. Masi, A.T., Rodnan, G.P., Medsgar, T.A.Jr., et al. Preliminary criteria for the classification of systemic sclerosis (Scleroderma). Arthritis Rheum 1980, 23, 581–90.

    PubMed  Google Scholar 

  16. Masi, A.T. Classification of systemic sclerosis (Scleroderma) Eds: Black, C.M., Myers, A.R. In: Systemic Sclerosis (Scleroderma) New York, Gower, 1985, 7–15.

    Google Scholar 

  17. Walshe, J.M. Penicillamine: a new oral therapy for Wilson's disease. Am J Med 1956, 2, 487–95.

    Google Scholar 

  18. Crawhall, J.C., Scoroen, E.F., Watts, R.E.W. Effects of pencillamine on cystinuria. Br Med J 1963, 1, 588–90.

    Google Scholar 

  19. Jaffe, I.A. Penicillamine treatment of rheumatoid arthritis: effect on immune complexes. Ann NY Acad Sci 1975, 256, 330–337.

    PubMed  Google Scholar 

  20. Jain, S., Scherer, P.J., Samourian, S. A controlled trial of D-penicillamine therapy in primary biliary cirrhosis. Lancet 1977, 1, 831–34.

    PubMed  Google Scholar 

  21. Dickson, E.R. The syndrome of primary biliary cirrhosis. J Rheumatol 1981, 8, 121–23.

    Google Scholar 

  22. Nimmi, M.E. A defect in the intramolecular and intermolecular cross-linkage of collagen caused by pencillamine. I. Metabolic and functional abnormalities in soft tissues. J Biol Chem 1968, 243, 1457–1466.

    PubMed  Google Scholar 

  23. Nimmi, M.E. Pencillamine and collagen metabolism. Scand J Rheumatol 1979, 8 (Suppl. 28), 71–8.

    PubMed  Google Scholar 

  24. Herbert, C.M., Lindberg, K.A., Jayson, M.I.V., Barley, A.J. Biosynthesis and maturation of skin collagen in scleroderma and effect of D-penicillamine. Lancet 1974, 1, 187–92.

    PubMed  Google Scholar 

  25. Uitto, J., Helin, P., Rasmussen, O., Lorenzen, I. Skin collagen in patients with scleroderma: biosynthesis and maturation in vitro, and the effects of D-penicillamine. Ann Clin Res 1970, 2, 228–34.

    PubMed  Google Scholar 

  26. Shapiro, L.S., Prince, R.K., Buckingham, R.B., Rodnan, G.P. D-penicillamine treatment of progressive systemic sclerosis (scleroderma). A comparison of clinical and in vitro. J Rheumatol 1983, 10, 316–18.

    PubMed  Google Scholar 

  27. Lipsky, P.E., Ziff, M. Inhibition of human helper T cell function in vitro by D-penicillamine and CuS04. J Clin Invest 1980, 65, 1069–76.

    PubMed  Google Scholar 

  28. LeRoy, E.C. Increased collagen synthesis by scleroderma skin fibroblasts in vitro. J Clin Invest 1974, 54, 880–89.

    PubMed  Google Scholar 

  29. Buckingham, R.B., Prince, R.K., Rodnan, G.P. et al. Increased collagen accumulation in dermal fibroblasts cultures from patients with PSS. J Lab Clin Med 1978, 92, 5–21.

    PubMed  Google Scholar 

  30. Buckingham, R.B., Prince, R.K., Rodnan, G.P. Progressive systemic sclerosis, dermal fibroblasts synthesize increased amounts of glycoseaminoglycans. J Lab Clin Med 1983.

  31. Harkness, M.L.R., Harkness, R.D. Effects of sulphydryl reagents on a mechanical property of skin. Nature 1966, 211, 496.

    PubMed  Google Scholar 

  32. Barley, A.J. The nature of collagen. Comprehensive Biochemistry. Eds: M. Glorkin, E.H. Stotz. Elsevier, Amsterdam. 1968, vol. 263 pp. 247.

    Google Scholar 

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Authors and Affiliations

  1. Department of Medicine, Faculty of Medicine, Kuwait University, Kuwait

    M. A. Sattar (Associate Professor Medicine and Consultant Rheumatologist), R. T. Guindi & T. N. Sugathan

  2. Community Medicine, Faculty of Medicine, Kuwait University, Kuwait

    M. A. Sattar (Associate Professor Medicine and Consultant Rheumatologist), R. T. Guindi & T. N. Sugathan

Authors
  1. M. A. Sattar
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  2. R. T. Guindi
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  3. T. N. Sugathan
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Sattar, M.A., Guindi, R.T. & Sugathan, T.N. Penicillamine in systemic sclerosis: A reappraisal. Clin Rheumatol 9, 517–522 (1990). https://doi.org/10.1007/BF02030514

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