Penicillamine

Abstract

This very complete article reviews the relationship of penicillamine to rheumatic disease therapy. This review includes a historical outline from its initial isolation through its early use in Wilson's disease in cystinuria and more recently its use with rheumatoid vasculitis and rheumatoid arthritis. The chemistry, pharmacology and pharmacokinetics as they are presently understood, are discussed. In general, while a number of theories are discussed as to pharmacological action, no single explanation is clearly responsible for the observable result in rheumatoid arthritis. The therapeutic discussion covers the role in Wilson's disease, cystinuria and rheumatoid arthritis. In rheumatoid arthritis, the rationale for current dosage schedules is given, side effects and their relationship to dosage in HLA genetics are adequately covered. The conclusion is that penicillamine is an effective agent in the treatment of this disease.