Osteoporosis in the rheumatoid hand--the effects of treatment with D-penicillamine and oral gold salts.
Osteoporosis is a common and important feature of rheumatoid disease which can be further influenced by the treatment administered. D-penicillamine, a lathyritic agent, can also theoretically hasten the osteoporotic process through its effect on collagen metabolism. In the present study the effects of the long-term second-line drugs D-penicillamine and oral gold (Auranofin) on bone density are presented. All the patients studied lost bone mineral over the 3-year period, but continuous D-penicillamine therapy for 1 year reversed this trend. Oral gold did not have the same effect. Measurements of bone density are an accurate indirect measurement of hand function, and there is a good correlation between hand function and the progress of osteoporosis. It is therefore suggested that treatment with D-penicillamine reverses the tendency to lose bone mineral improving synovitis, thus leading to improved hand function.
D000893:Anti-Inflammatory Agents / Q000009:adverse effects*; D001172:Arthritis, Rheumatoid / Q000150:complications / Q000188:drug therapy*; D001310:Auranofin; D006051:Aurothioglucose / Q000009:adverse effects / Q000031:analogs & derivatives*; D005260:Female; D006046:Gold / Q000031:analogs & derivatives*; D006801:Humans; D008297:Male; D008663:Metacarpus / Q000000981:diagnostic imaging*; D008875:Middle Aged; D010024:Osteoporosis / Q000139:chemically induced* / Q000150:complications / Q000000981:diagnostic imaging; D010396:Penicillamine / Q000009:adverse effects*; D011859:Radiography; D013997:Time Factors
D000893:Anti-Inflammatory Agents; D006051:Aurothioglucose; D001310:Auranofin; D006046:Gold; D010396:Penicillamine