EUROPEAN LEAGUE AGAINST RHEUMATISM STUDY OF ADVERSE REACTIONS TO D-PENICILLAMINE

An international multicentre study of adverse reactions to D-penicillaminewas undertaken on 2879 patients exposed to the drug—1491of them a prospective sample. The majority of patients werebeing treated for rheumatoid arthritis. Over a period of 18months, 319 (21%) of patients in the prospective sample developedadverse reactions necessitating drug withdrawal; two thirdsof these occurred during the first 3 months of treatment. Themost frequently-occurring adverse reactions involved skin (6%),kidneys (4%), gastro-intestinal tract (4%) and haemopoiesis(3%). Adverse effects, considered to be serious by the reportingphysician, included fever and leucopenia during the early weeksof treatment and, after some months of drug exposure, proteinuria,myasthenia gravis, dyspnoea and pemphigus. Two patients died,one of fulminating septicaemia and the other was found at autopsyto have had multiple lung abscesses following unexplained anaemiaand hemiparesis. KEY WORDS: D-Penicillamine, Rheumatoid arthritis, Adverse drug reaction