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D-Penicillamine Therapy in Progressive Systemic Sclerosis (Scleroderma): A Retrospective Analysis

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Grant support: grants AM 21393 and FR-00056, National Institutes of Health; Mr. and Mrs. Louis Kunian, Atlanta, Georgia; and the RGK Foundation, Austin, Texas.

▸Requests for reprints should be addressed to Virginia D. Steen, M.D.; Department of Medicine, University of Pittsburgh School of Medicine, 985 Scaife Hall, Pittsburgh, PA 15261.

Pittsburgh, Pennsylvania

© 1982 American College of PhysiciansAmerican College of Physicians

Ann Intern Med. 1982;97(5):652-659. doi:10.7326/0003-4819-97-5-652
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In a retrospective study on progressive systemic sclerosis, we compared 73 patients who had received D-penicillamine therapy for a minimum of 6 consecutive months with 45 patients who had not received this drug. All patients had diffuse sclerodermatous skin changes and early disease (less than 3-years duration). D-Penicillamine was prescribed for an average of 24 months (range, 6 to 68 months) with a maximum daily dose of 500 to 1500 mg (median, 750 mg). During a mean follow-up interval of 38 months, the degree and extent of skin thickness, determined on physical examination, decreased considerably more in the patients treated with D-penicillamine than in patients in the comparison group (p = 0.07). The rate of new visceral organ involvement was reduced in patients treated with D-penicillamine, especially for the kidney (p = 0.01). Patients treated with D-penicillamine had a greater 5-year cumulative survival rate (88% versus 66%, p < 0.05). Therapy with colchicine (23 patients) or immunosuppressive agents (26 patients) was not associated with these improvements.





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