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Physicians planning to use penicillamine should thoroughly familiarize themselves with its toxicity, special dosage considerations, and therapeutic benefits. Penicillamine should never be used casually. Each patient should remain constantly under the close supervision of the physician. Patients should be warned to report promptly any symptoms suggesting toxicity.
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CUPRIMINE SUMMARY
CUPRIMINE ®
CAPSULES
(PENICILLAMINE)
Penicillamine is a chelating agent used in the treatment of Wilson's disease. It is also used to reduce cystine excretion in cystinuria and to treat patients with severe, active rheumatoid arthritis unresponsive to conventional therapy (see INDICATIONS).
CUPRIMINE is indicated in the treatment of Wilson's disease, cystinuria, and in patients with severe, active rheumatoid arthritis who have failed to respond to an adequate trial of conventional therapy. Available evidence suggests that CUPRIMINE is not of value in ankylosing spondylitis.
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NEWS HIGHLIGHTS
Published Studies Related to Cuprimine (Penicillamine)
High-dose versus low-dose D-penicillamine in early diffuse systemic sclerosis trial: lessons learned. [2004.02]
OBJECTIVES: To review important findings, or lessons, that were learned about measures of response, design, conduct, and analysis of a randomized, controlled trial (RCT), even though the trial failed to demonstrate efficacy of d-penicillamine... CONCLUSIONS: Even in studies that are therapeutically "negative," careful evaluation of the data can examine other hypotheses and thereby provide important insights into other aspects of trial design, outcome measures, patient function, and trial conduct.
The Disability Index of the Health Assessment Questionnaire is a predictor and correlate of outcome in the high-dose versus low-dose penicillamine in systemic sclerosis trial. [2001.03]
OBJECTIVE: To explore the clinical implications of a score of > or =1.0 on the Disability Index of the Health Assessment Questionnaire (HAQ DI) at the first patient visit, and to examine the implications of improvement in HAQ DI score over 2 years in a cohort of systemic sclerosis (SSc) patients with diffuse cutaneous scleroderma... CONCLUSION: A baseline HAQ DI score of > or =1.0 predicted mortality over 4 years. Improvement in the HAQ DI score in these patients with diffuse scleroderma was associated with improvement in skin thickening, hand function, oral aperture, lung function, signs of arthritis, serum creatinine level, and the investigator's global assessment of improvement. The HAQ DI is a self-administered questionnaire that SSc patients can complete easily and rapidly and that gives the practicing physician important information about prognosis, patient status, and changes in disease course over time.
D-penicillamine is not an effective treatment in systemic sclerosis. [2001]
Based on open studies. D-penicillamine (DPA) has been used for the treatment of systemic sclerosis (SSc) but we believe the controlled trial of this drug in SSc does not support its use to treat this disease.
Evaluation of antineutrophil cytoplasmic antibody seroconversion induced by minocycline, sulfasalazine, or penicillamine. [2000.11]
OBJECTIVE: Case reports have suggested that minocycline, sulfasalazine, and penicillamine are associated with antineutrophil cytoplasmic antibody (ANCA)-positive vasculitis. This study evaluated ANCA seroconversion due to these agents in serum samples prospectively collected in randomized, double-blind, controlled trials... CONCLUSION: From our study results, there was no suggestion of ANCA seroconversion induced by minocycline, sulfasalazine, or penicillamine. However, these findings do not rule out the possibility of rare, sporadic cases of either ANCA seroconversion or true drug-induced vasculitis with these drugs.
Penicillamine in the treatment of systemic sclerosis. [1999.10]
Retrospective studies have suggested that D-penicillamine (DPA) in conventional high dosages (750-1000 mg/d) may be efficacious in treating the skin and visceral complications of systemic sclerosis (SSc), particularly when used early in the disease. The course of skin thickening and the occurrence of renal crisis and of death were examined in a recent randomized controlled 2-year trial of high- dosage DPA (750-1000 mg/d) versus low-dose DPA (125 mg every other day)...
Clinical Trials Related to Cuprimine (Penicillamine)
Penicillamine Chelation for Children With Lead Poisoning [Active, not recruiting]
Childhood Lead Poisoning is a widespread disease that has few effective treatments. The
specific aims of this proposed clinical trial are threefold:
- To determine whether a six-week course of a newly formulated d-penicillamine suspension
will effectively reduce blood lead level in children aged 6 months to 16 years with
blood lead levels of 15-25 μg/dL.
- To determine whether d-penicillamine chelation produces a sustained reduction in blood
lead level in comparison with succimer and other lead chelators which always produce a
significant post-treatment "rebound".
- To determine whether chelation with d-penicillamine improves the physiologic
disturbances that can be measured in children with blood lead levels in this range.
Penicillamine, Low Copper Diet, and Radiation Therapy in Treating Patients With Glioblastoma [Active, not recruiting]
RATIONALE: Penicillamine may stop the growth of glioblastomas by stopping blood flow to the
tumor. A diet low in copper may interfere with the growth of brain tumor cells. Radiation
therapy uses high-energy x-rays to damage tumor cells. Combining these therapies may be
effective in treating glioblastoma.
PURPOSE: Phase II trial to study the effectiveness of penicillamine, a low copper diet, and
radiation therapy in treating patients who have newly diagnosed glioblastoma.
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Page last updated: 2006-01-31
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