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Depen (Penicillamine) - Summary

 
 



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.

 

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.
See all Depen indications & dosage >>

NEWS HIGHLIGHTS

Media Articles Related to Depen (Penicillamine)

People with opioid dependence in recovery show 're-regulation' of reward systems
Source: Alcohol / Addiction / Illegal Drugs News From Medical News Today [2014.12.13]
Within a few months after drug withdrawal, patients in recovery from dependence on prescription pain medications may show signs that the body's natural reward systems are normalizing, reports a study...

Inflammatory Markers May Predict Alcohol Dependence
Source: Medscape Psychiatry & Mental Health Headlines [2014.12.10]
Proinflammatory cytokines such as RANTES, which has been implicated before in various psychiatric disorders, may be correlated with impulsivity in alcoholism.
Medscape Medical News

How Good Is Healthcare for Kids? Depends on Your ZIP Code
Source: MedPage Today Pediatrics [2014.12.09]
(MedPage Today) -- No gold standard means no standard care for kids.

Added benefit not proven for nalmefene to treat alcohol dependence
Source: Alcohol / Addiction / Illegal Drugs News From Medical News Today [2014.12.08]
Indirect comparison is difficult to interpret because of differences in patients and treatment goalsNalmefene (trade name Selincro) has been approved since February 2013 for people with alcohol...

Family Hx Still Independent Risk Factor for RA
Source: MedPage Today Rheumatology [2014.12.06]
(MedPage Today) -- Swedish study indicates genotyping/environmental risks don't tell whole story.

more news >>

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 for preventing retinopathy of prematurity in preterm infants. [2013]
CONCLUSIONS: Administration of prophylactic D-penicillamine in preterm

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.

more studies >>

Clinical Trials Related to Depen (Penicillamine)

Effect of Increasing Doses of Cystine Binding Thiol Drugs on Cystine Capacity in Patients With Cystinuria [Recruiting]
The purpose of this study is to evaluate the effect of escalating doses of cystine biding thiol drugs, including tiopronin and d-penicillamine, on the urinary cystine capacity, which is a measure of the amount of cystine in the urine, in patients with cystinuria. The overall goal will be to help guide therapy and ultimately minimize unnecessary side effects caused by larger doses.

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.

Cystine Capacity Clinical Study (CysCap) [Recruiting]
The purpose of this study is to determine whether urinary cystine capacity, an assay used to measure the amount of cystine in the urine, can be used to predict stone recurrence in patients with cystinuria.

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: 2014-12-13

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