Maintenance dose of penicillamine in rheumatoid arthritis: a comparison between a standard and a response-related flexible regimen.
Maintenance dose of penicillamine in rheumatoid arthritis: a comparison between a standard and a response-related flexible regimen.
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类风湿性关节炎中青霉胺的维持剂量：标准方案和与反应相关的灵活方案之间的比较。
DOI：
10.1136/ard.38.5.429
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发表时间：
1979
影响因子：
27.4
通讯作者：
W. Lyle
中科院分区：
文献类型：
--
作者：
H. Hill;A. Hill;A. T. Day;R. Brown;J. Golding;W. Lyle
类风湿性关节炎（RA）对青霉胺的反应存在很大的个体差异，一些患者从非常小的剂量中获益。每日750 mg的剂量被广泛认为是标准剂量，虽然他们的RA通常有反应，但许多患者因青霉胺的不良反应而停止治疗。从长远来看，更灵活的处方政策可能会更成功，并在一组20名患者中进行了测试，另一组接受“标准”方案，每个人都以低剂量水平开始治疗。在那些仅在反应差时增加剂量的患者中，17人以平均每日308 mg的维持剂量完成了1年的治疗，但另一组中仅11人以平均每日613 mg的剂量完成了1年的治疗。仅在后一组中发现的蛋白尿导致6例退出，均为625 mg/天或以上剂量。完成12个月治疗的两组成员中类风湿活动的减少程度似乎大致相同。青霉胺最初应给予低剂量，只有在至少4周后缺乏反应时才应增加剂量。
There is much individual variation in the response of rheumatoid arthritis (RA) to penicillamine, some patients deriving benefit from very small doses. A dose of 750 mg daily is widely regarded as standard, and, while their RA commonly responds, many patients discontinue treatment because of adverse reactions to penicillamine. A more flexible prescribing policy might be more successful in the long term and was tested in 1 group of 20 patients, another receiving a 'standard' regimen, each beginning treatment at a low dose level. Of those who were given increases of dose only if response was poor 17 completed 1 year of treatment on an average maintenance dose of 308 mg daily, but only 11 of the other group on an average dose 613 mg daily. Proteinuria, which was found only in the latter group accounted for 6 withdrawals, all at doses of 625 mg daily or above. The reduction in rheumatoid activity appeared to be of about the same degree among the members of both groups who completed 12 months of treatment. Penicillamine should be given initially in a low dose and this should be raised only if there is lack of response after at least 4 weeks.