title: Treatment of primary Sjögren's syndrome with D-penicillamine: a pilot study.
abstract: BACKGROUND
  Up to now no satisfying systemic treatment is available for patients with primary Sjögren's syndrome.
  
  
  METHODS
  In a prospective, open study we investigated the effect of D-penicillamine (first three months 250 mg/day, next three months 500 mg/day) on clinical and immunological parameters in 19 patients with primary Sjögren's syndrome and a mean disease duration of 3.8 years.
  
  
  RESULTS
  Eight patients had to stop treatment mainly due to severe (reversible) loss of taste. Clinically, a statistically significant increase in basal salivary flow was observed after three months (p<0.05). In addition, improvement was noted in the Schirmer test and stimulated parotid salivary flow after six months, but these differences were not statistically significant. Laboratory values showed a decrease in ESR (p<0.05) and levels of IgA and IgM (both p<0.02) after six months, a decrease in levels of IgA-Rf and IgM-Rf after three months (both p<0.05), and an increase in haemoglobin level (p<0.05).
  
  
  CONCLUSIONS
  From this pilot study we conclude that the treatment of primary Sjögren's syndrome with D-penicillamine has only marginal beneficial effects. Together with its clear side effects this means that D-penicillamine is unsuitable for this indication.
authors.affiliation: Department of Rheumatology, Sint Antonius Hospital, Koekoekslaan 1, 3430 EM Nieuwegein, the Netherlands.
authors.forename: E J
authors.initials: EJ
authors.lastname: ter Borg
authors.forename: H C M
authors.initials: HC
authors.lastname: Haanen
authors.forename: F J L M
authors.initials: FJ
authors.lastname: Haas
authors.forename: J H G M
authors.initials: JH
authors.lastname: Bistervels
authors.forename: F W
authors.initials: FW
authors.lastname: Huisman
authors.forename: J A
authors.initials: JA
authors.lastname: Kerckhaert
authors.forename: C G M
authors.initials: CG
authors.lastname: Kallenberg
mesh_terms: D000328:Adult; D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D004341:Drug Evaluation; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009426:Netherlands; D010396:Penicillamine / Q000009:adverse effects / Q000627:therapeutic use*; D010865:Pilot Projects; D012859:Sjogren's Syndrome / Q000188:drug therapy* / Q000378:metabolism
chemical_list: D018501:Antirheumatic Agents; D010396:Penicillamine