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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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DEPEN SUMMARY
DEPEN®
(penicillamine tablets, USP)
Titratable Tablets
Penicillamine is 3-mercapto-D-valine, a disease modifying antirheumatic drug. It is a white or practically white, crystalline powder, freely soluble in water, slightly soluble in alcohol, and insoluble in ether, acetone, benzene, and carbon tetrachloride. Although its configuration is D, it is levorotatory as usually measured.
DEPEN 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 DEPEN is not of value in ankylosing spondylitis.
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NEWS HIGHLIGHTSMedia Articles Related to Depen (Penicillamine)
First Guidelines For Treating Non-Transfusion-Dependent Thalassaemia Introduced At European Haematology Association Meeting
Source: Health News from Medical News Today [2013.06.15]
New guidelines released by the Thalassaemia International Federation (TIF) address the Management of Non-Transfusion Dependent Thalassaemias (NTDT) and are a first of their kind in the field of medical haematology. The guidelines, presented today at the 18th Congress of the European Haematology Association (EHA), provide a consensus of international expert opinion based on the latest data in the field, and were developed to give clinicians easy-to-follow protocols to better identify and manage this patient population, who are often overlooked or under-diagnosed...
Many Docs Still Don't Understand Opioid Dependence
Source: Medscape Today Headlines [2013.06.14]
Misperceptions about opioid dependence and how to treat it persist for both the public and primary care physicians, new research suggests.
Medscape Medical News
ADA: Independent Review of Incretins and Pancreatitis, Cancer
Source: Medscape Diabetes & Endocrinology Headlines [2013.06.11]
The ADA is the latest organization to call for an independent review into GLP-1-based therapies for type 2 diabetes to see whether they increase the risk of pancreatitis and pancreatic cancer
Medscape Medical News
Pain Level After Car Crash Could Depend on Your Genes, Studies Say
Source: MedicineNet Neck Pain Specialty [2012.10.17]
Title: Pain Level After Car Crash Could Depend on Your Genes, Studies Say
Category: Health News
Created: 10/16/2012 4:06:00 PM
Last Editorial Review: 10/17/2012 12:00:00 AM
Basic Brain Organization Means What You Hear Could Depend On What Your Hands Are Doing
Source: Dyslexia News From Medical News Today [2012.10.16]
A new finding could lead to strategies for treating speech loss after a stroke and helping children with dyslexia; interestingly, it might also explain one reason people perceive a presidential candidate's speech differently New research links motor skills and perception, specifically as it relates to a second finding - a new understanding of what the left and right brain hemispheres "hear...
Published Studies Related to Depen (Penicillamine)
Oral D-penicillamine for the prevention of retinopathy of prematurity in very low birth weight infants: a randomized, placebo-controlled trial. [2010.09]
PURPOSE: To compare prophylactic enteral D-penicillamine (DPA) with placebo for prevention of 'retinopathy of prematurity (ROP) or death' among very low birth weight (VLBW) infants... CONCLUSION: Prophylactic enterally administered DPA suspension in a dose 100 mg/kg/dose 8 h for 3 days, followed by 50 mg/kg once per day for next 11 days, does not prevent 'any stage ROP or death' or 'ROP requiring treatment' in VLBW infants. DPA is well tolerated and does not have any major short-term adverse effects. (c) 2010 The Author(s)/Journal Compilation (c) 2010 Foundation Acta Paediatrica.
Oral D-penicillamine for the prevention of retinopathy of prematurity in very low birth weight infants: a randomized, placebo-controlled trial. [2010.04.16]
Abstract Purpose: To compare prophylactic enteral D-penicillamine (DPA) with placebo for prevention of 'retinopathy of prematurity (ROP) or death' among very low birth weight (VLBW) infants. Methods: This was a double-blind, single-centre, randomized, placebo-controlled trial with stratification (for birth weight <1250 and >/=1250 g) and blocking...
D-penicillamine, a potent melanogenesis inhibitor, lacks any depigmenting effect on black guinea pig skin: the first randomized, evaluator-blinded, vehicle-controlled, in vivo study. [2011.06]
D-penicillamine is a melanogenesis inhibitor. This in vivo study on ten black guinea pigs using a 5% D-penicillamine ointment showed its lack of any skin-lightening effect.The potential reasons for this ineffectiveness are discussed in the paper, which could be very helpful for researchers exploring new skin-lightening agents.
D-penicillamine elastosis perforans serpiginosa: description of two cases and review of the literature. [2011.04.15]
Long term D-penicillamine (DPA) therapy to treat Wilson disease can induce elastosis perforans serpiginosa (EPS), a very rare degenerative skin disease characterized by a transepidermal elimination of elastic fiber aggregates.
Involvement of T helper 17 cells in D-penicillamine-induced autoimmune disease in Brown Norway rats. [2011.04]
Idiosyncratic drug reactions (IDRs) are poorly understood, but their clinical characteristics suggest that they are immune mediated. Penicillamine-induced autoimmunity in Brown Norway rats has been utilized as an animal model for mechanistic studies of one type of IDR because it closely mimics the autoimmune syndromes that it causes in humans...
Clinical Trials Related to Depen (Penicillamine)
Study of Positron Emission Tomography and Computed Tomography in Guiding Radiation Therapy in Patients With Stage III Non-Small Cell Lung Cancer [Recruiting]
RATIONALE: Imaging procedures, such as positron emission tomography (PET) scan and CT scan,
may help doctors plan radiation therapy for patients with non-small cell lung cancer.
PURPOSE: This randomized phase II trial studies how well PET/CT scan work in guiding
radiation therapy compared to standard radiation therapy treatment in patients with stage
III non-small cell lung cancer.
Efficacy of Invitro Expanded Bone Marrow Derived Allogeneic Mesenchymal Stem Cell Transplantation Via Portal Vein or Hepatic Artery or Peripheral Vein in Patients With Wilson Cirrhosis [Recruiting]
Wilson's disease is an autosomal recessive genetically inherited disorder of copper
metabolism, causing neurological, psychiatric and liver disease. The ATP7B gene on the 13th
chromosome is responsible for the disease. Liver has a critical role on copper metabolism.
It is the main site of copper accumulation and bile secretion is the only physiologic way of
copper elimination. Due to defective production of ceruloplasmin which carries copper, wide
amount of free copper precipitates throughout the body but particularly in the liver, eyes
and brain. Patients are bound to lifelong chelating agents such as penicillamine, trientine
and tetramine dihydrochloride. Unfortunately, these medications may cause severe
side-effects such as hypersensitivity reactions, bone marrow suppression, auto-immune
disease and sideroblastic anemia. Medical treatment of liver cirrhosis, the last stage of
the illness that leads to morbidity and mortality in the Wilson Disease, is difficult. Liver
transplantation is still the most effective treatment for the patients with liver cirrhosis
in Wilson Disease. However, serious problems are accompanied with liver transplantation.
Lack of liver donors, complications during and after the surgery, graft rejection and high
costs are the main problems.
There are cells in the human body that are capable to renew themselves and differentiate to
a diverse range of specialized cell types. These are called "stem cells". Stem cells can be
differentiated to specialized cells in appropriate medias in the laboratory. Recently, the
differentiation potential of mesenchymal stem cells into hepatocytes is proved by
demonstrating hepatocytes containing Y chromosome in the female who has had bone marrow
transplantation from male donors. In many laboratory studies, it is observed that human bone
marrow derived mesenchymal stem cells, transplanted to animals with induced liver damage,
differentiate into the albumin producing hepatocytes without fusion. By these studies, it is
understood that mesenchymal stem cells are more potent than other bone marrow elements in
context of differentiation to hepatocytes. Even though the number of studies on human for
the same purpose is few, findings are supporting those of animal experiments. Mesenchymal
stem cells are non-immunogenic. Safety and feasibility of allogeneic transplantations
between individuals without need of immunosuppressive drug regimen are proven. Proofs of
correcting metabolic defects by this way are also presented in some publications. For the
reasons mentioned above, allogeneic mesenchymal stem cell transplantation is a promising
treatment modality especially for the hereditary metabolic diseases. By this way,
non-immunogeneic mesenchymal stem cells which have healthy genetic structure, can
manufacture the required enzyme, will be repopulated in the damaged tissue and contribute to
the clinical improvement.
In this study, mesenchymal stem cells will be derived from healthy volunteer donor's bone
marrow and be expanded in-vitro, and then 1 million cells per kg will be infused to patients
with liver cirrhosis related to Wilson disease, 50 million cells via hepatic artery and the
remaining cells via peripheral vein. It is aimed to enable liver regeneration, decrease
fibrosis rate, improve patient's health conditions, increase ceruloplasmin synthesis,
ameliorate disorder of copper metabolism, decrease the need for chelating agents, increase
living standards of patients, and prolong waiting time for liver transplantation. Finally it
is aimed to establish a new and regenerative treatment protocol alternative to liver
transplantation. For observation of clinical and laboratory improvement, patients are
planned to be monitored by histopathologic examination of liver biopsies before and at 6th
month after the treatment, monthly biochemical and hematologic blood tests and periodic
radiologic examinations. This is a hopeful, avant garde and sophisticated study which may
constitute new horizons in context of cellular therapies.
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Page last updated: 2013-06-15
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