D-penicillamine in patients with rheumatoid arthritis serum levels, pharmacokinetic aspects, and correlation with clinical course and side effects

✍ Scribed by A. O. Muijsers; R. J. Van De Stadt; A. M. A. Henrichs; H. J. W. Ament; J. K. Van Der Korst

• Publisher: John Wiley and Sons
• Year: 1984
• Tongue: English
• Weight: 666 KB
• Volume: 27
• Category: Article
• ISSN: 0004-3591
• DOI: 10.1002/art.1780271206

✦ Synopsis

After administration of D-penicillamine to patients with rheumatoid arthritis, measurements of serum level and urinary excretion showed half-life times of 1.6 hours in the rapid phase and 4-6 days in the slow phase. The latter evidence suggests that tissue pooling occurs. With a dosage of 750 mglday, basic serum levels of 100 pM are gradually reached. Serum D-penicillamine levels were shown to be the same for patients who responded well to treatment, those who did not respond, and for patients who had adverse side effects as well as those who had none. Intestinal resorption decreased when D-penicillamine was taken close to meals and was greatly reduced by iron preparations.

For several decades D-penicillamine (p,pdimethylcysteine) has been established as an essential drug in the treatment of Wilson's disease (1-3) and cystinuria (2-5). It has also had limited application in conditions such as heavy-metal poisoning (3,6), primary biliary cirrhosis (3,7), and chronic juvenile polyarthritis (3,8). During the last 10 years, D-penicillamine has become one of the major second-line drugs From the Jan van Breemen Institute, Amsterdam and the