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Toxicity of D-Penicillamine in Rheumatoid Arthritis

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University of Virginia School of Medicine; Charlottesville, Virginia

Ann Intern Med. 1980;92(1):120-122. doi:10.7326/0003-4819-92-1-120
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The studies of Isreal Jaffe early in the 1960s clearly indicated that D-penicillamine was highly effective in treating severe rheumatoid arthritis, particularly rheumatoid arthritis with visceral involvement. His initial observations were confirmed by a carefully controlled English multicenter trial (1). Efficacy of the drug at doses up to 1500 mg/d in treating severe rheumatoid arthritis is not in doubt. In rheumatoid arthritis penicillamine depolymerizes rheumatoid factor. This depolymerization is evidenced during therapy in the falling titer of rheumatoid factor, disappearance of rheumatoid nodules, and improvement in the manifestations of the arthritis. In the English trial (1) the number of the


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