D-penicillamine Effective in Rheumatoid Arthritis

Original Article
Treatment of hemophilic arthritis with D-penicillamine: A preliminary
report
Dr. James J. Corrigan Jr. 1 3 5 *, Karen S. Kolba 4, Eric P. Gall 2 4,
Joyce Trombley 4, Mary Lou Damiano 5, Keith Meredith 6, Monette Jeter
7
1Departments of Pediatrics, University of Arizona Health Sciences
Center, Tucson
2Departments of Internal Medicine, University of Arizona Health
Sciences Center, Tucson
3Departments of Sections of Pediatric Hematology-Oncology, University
of Arizona Health Sciences Center, Tucson
4Departments of Rheumatology, Allergy, and Immunology, University of
Arizona Health Sciences Center, Tucson
5Mountain States Regional Hemophilia Center, University of Arizona
Health Sciences Center, Tucson
6Southwest Arthritis Center, University of Arizona Health Sciences
Center, Tucson
7Coagulation Research Laboratory, University of Arizona Health
Sciences Center, Tucson


*Correspondence to James J. Corrigan Jr., Professor of Pediatrics,
Director, Mountain States Regional Hemophilia Center, University of
Arizona Health Sciences Center, Tucson AZ 85724

Funded by:
Thrasher Research Funds
National Hemophilia Foundation

Keywords
hemophilia · synovitis · rabbits · D-penicillamine


Abstract
Current medical management programs for established joint diseases in
hemophiliacs are unsatisfactory and do not modify the eventual
outcome. D-penicillamine, a drug effective in the proliferative
synovitis of rheumatoid arthritis, was evaluated in a rabbit model of
hemarthroses-induced arthritis and in four hemophiliacs with chronic
synovitis. The animals had intra-articular injections of citrate (left
knees) and autologous citrated whole blood (right knees). Eight weeks
later, the rabbits were divided into two groups: no treatment and D-
penicillamine (50 mg/kg/day, IM) until sacrificed at 6 months. The
saline-injected joints showed no inflammation and no iron deposition.
The blood-injected knees showed iron deposition in both groups, the D-
penicillamine animals had marked suppression of chronic inflammation.
Of the four patients treated, three had clinical responses (reduction
in synovial thickness, reduction in number of bleeds in the affected
joint). One patient, who did not respond, developed mild-moderate
proteinuria. Those patients who responded received between 5.3 and 7.1
mg/kg/day of the drug. Mild abnormalities in platelet aggregation were
seen in the responders. This preliminary study suggests that D-
penicillamine is beneficial in the chronic synovitis/arthritis induced
by hemarthroses. Further trials are recommended.

Received: 13 August 1984; Accepted: 25 October 1984
Digital Object Identifier (DOI)

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http://tinyurl.com/28r997

PENICILLAMINE CAPSULES
Indication
Antidote to heavy metals (chelating agent).
Penicillamine is a heavy metal antagonist that chelates copper,
iron,mercury, lead, and probably other heavy metals as well as
cystine*.


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