A study of adjunctive copper sulphate treatment in patients with rheumatoid arthritis who have relapsed while taking D-penicillamine.

Author(s): Pullar T, Wrigley H, Newton K, Toothill C, Wright V

Affiliation(s): Clinical Pharmacology Unit, University of Leeds, The General Infirmary.

Publication date & source: 1991-01, Br J Clin Pharmacol., 31(1):105-7.

Publication type: Clinical Trial; Randomized Controlled Trial

Formation of a D-penicillamine-copper complex may be necessary for the anti-rheumatic effect of D-penicillamine. Thus, depletion of copper stores by D-penicillamine may eventually lead to relapse in D-penicillamine treated patients. Twenty-one patients who relapsed on D-penicillamine were randomised to copper sulphate 20 mg daily (n = 13) or matched placebo (n = 8) in addition to penicillamine daily for 16 weeks. Urinary copper was increased in the copper treated patients but no statistically significant or clinically important improvement occurred in either group.