D-penicillamine in systemic sclerosis? Yes!
The use of D-penicillamine in systemic sclerosis (SSc) has been controversial. We have reviewed the major published studies on this drug in SSc with diffuse cutaneous (dc) involvement and summarized our own recent experience in dcSSc patients treated with and without D-penicillamine. We conclude that D-penicillamine favourably alters the natural history of skin involvement in dcSSc, even when used in low dose. Furthermore, recurrence of diffuse skin change after discontinuation of D-penicillamine and improvement in skin thickening after reinitiation of the drug support its effectiveness. We believe that the rheumatologic community should use D-penicillamine in patients with early dcSSc.
Medsger
T A
TA
Division of Rheumatology and Clinical Immunology, University of Pittsburgh School of Medicine, PA 15261, USA. medsger@msx.dept-med.pitt.edu
Lucas
M
M
Wildy
K S
KS
Baker
C
C
D018501:Antirheumatic Agents / Q000627:therapeutic use*; D003094:Collagen / Q000187:drug effects / Q000378:metabolism; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005355:Fibrosis / Q000188:drug therapy; D006801:Humans; D007166:Immunosuppressive Agents / Q000494:pharmacology; D010396:Penicillamine / Q000627:therapeutic use*; D016032:Randomized Controlled Trials as Topic; D012595:Scleroderma, Systemic / Q000188:drug therapy*; D012871:Skin Diseases / Q000188:drug therapy; D016896:Treatment Outcome
D018501:Antirheumatic Agents; D007166:Immunosuppressive Agents; D003094:Collagen; D010396:Penicillamine