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Taal BG, Schalm SW, Ten Kate FW, et al. Low therapeutic value of D-penicillamine in a short-term prospective trial in primary biliary cirrhosis. Liver. 1983;3(6):345-52doi: 10.1111/j.1600-0676.1983.tb00887.x.
Taal, B. G., Schalm, S. W., Ten Kate, F. W., Van Berge Henegouwen, G. P., & Brandt, K. H. (1983). Low therapeutic value of D-penicillamine in a short-term prospective trial in primary biliary cirrhosis. Liver, 3(6), 345-52. https://doi.org/10.1111/j.1600-0676.1983.tb00887.x
Taal, B G, et al. "Low therapeutic value of D-penicillamine in a short-term prospective trial in primary biliary cirrhosis." Liver vol. 3,6 (1983): 345-52. doi: https://doi.org/10.1111/j.1600-0676.1983.tb00887.x
Taal BG, Schalm SW, Ten Kate FW, Van Berge Henegouwen GP, Brandt KH. Low therapeutic value of D-penicillamine in a short-term prospective trial in primary biliary cirrhosis. Liver. 1983 Dec;3(6):345-52. doi: 10.1111/j.1600-0676.1983.tb00887.x. PMID: 6366419.
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Liver. 1983 Dec;3(6):345-52. doi: 10.1111/j.1600-0676.1983.tb00887.x.

Low therapeutic value of D-penicillamine in a short-term prospective trial in primary biliary cirrhosis.

Liver

B G Taal, S W Schalm, F W Ten Kate, G P Van Berge Henegouwen, K H Brandt

PMID: 6366419 DOI: 10.1111/j.1600-0676.1983.tb00887.x

Abstract

A small double-blind controlled trial to evaluate the short-term effects of D-penicillamine therapy was carried out in 24 patients with primary biliary cirrhosis (PBC). The daily dose of D-penicillamine was increased monthly by 250 mg until a total of 1 g daily was reached. Two out of 11 patients (18%) were withdrawn because of side-effects, as also were 4 out of 13 (31%) patients receiving the placebo. Transient improvement in symptoms was observed in 4 of 11 patients on D-penicillamine, but also in 5 of 13 patients from the placebo group. The proportion of patients showing a fall in serum IgM, IgG and hepatic copper was significantly larger for the D-penicillamine group than for the placebo group. No improvement in liver tests was observed, but the progression of inflammatory periportal liver cell destruction (piecemeal necrosis) was retarded in patients on D-penicillamine (p = 0.02). Data analysis within the D-penicillamine group showed that lowering the dose of D-penicillamine to 500 mg daily abolished the effect on the serum immunoglobulins and hepatic copper. The beneficial effect of D-penicillamine therapy appears to be small and dose-related; side effects should not prevent its use, provided the drug is introduced slowly.

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