Treatment of primary Sjögren's syndrome with D-penicillamine: a pilot study.
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.
ter Borg
E J
EJ
Department of Rheumatology, Sint Antonius Hospital, Koekoekslaan 1, 3430 EM Nieuwegein, the Netherlands.
Haanen
H C M
HC
Haas
F J L M
FJ
Bistervels
J H G M
JH
Huisman
F W
FW
Kerckhaert
J A
JA
Kallenberg
C G M
CG
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
D018501:Antirheumatic Agents; D010396:Penicillamine