Intermittent treatment with D-penicillamine is effective in lower doses and with fewer adverse effects in patients with rheumatoid arthritis.

Abstract

OBJECTIVE:

To determine whether intermittent rather than daily administration of D-penicillamine (D-Pen) would effectively reduce the incidence of adverse effects without significantly diminishing the clinical benefits.

METHODS:

We conducted an open prospective trial comparing daily and intermittent schedules. Among 76 Japanese patients with rheumatoid arthritis (RA), 37 underwent daily treatment with D-Pen while 39 were given D-Pen intermittently (every Monday, Wednesday, and Friday).

RESULTS:

The mean D-Pen dose was 166.8 and 99.4 mg/day for daily and intermittent groups, respectively, the difference being highly significant (p < 0.0001, Mann-Whitney's U test). The incidence of adverse effects was significantly lower in the intermittent group. Both schedules significantly reduced the activity of RA, as evaluated by clinical and laboratory variables. No significant differences were observed in the degree of improvement between the 2 schedules.

CONCLUSION:

Intermittent therapy with D-Pen is an effective treatment for patients with RA and its higher degree of flexibility can lead to maximum efficacy for management of patients with RA.

• Authors: M Hakoda, A Taniguchi, N Kamatani, T Akahoshi, S Kashiwazaki
• Journal: The Journal of rheumatology (J Rheumatol) Vol. 21 Issue 9 Pg. 1637-41 (Sep 1994) ISSN: 0315-162X [Print] Canada
• PMID: 7799341 (Publication Type: Clinical Trial, Comparative Study, Controlled Clinical Trial, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Prednisolone
• Penicillamine

Topics

• Adult
• Arthritis, Rheumatoid (drug therapy)
• Data Interpretation, Statistical
• Drug Administration Schedule
• Drug Therapy, Combination
• Female
• Humans
• Male
• Middle Aged
• Penicillamine (administration & dosage, adverse effects, therapeutic use)
• Prednisolone (therapeutic use)
• Prospective Studies