Low-dose D-penicillamine therapy in rheumatoid arthritis. A controlled, double-blind clinical trial.
Low-dose D-penicillamine therapy in rheumatoid arthritis. A controlled, double-blind clinical trial.
复制标题
低剂量 D-青霉胺治疗类风湿性关节炎。
作者：
H. Williams;J. Ward;J. Reading;M. Egger;J. T. Grandone;J. T. Grandone;C. Samuelson;D. Furst;D. Furst;J. M. Sullivan;J. M. Sullivan;M. Watson;M. Watson;M. Guttadauria;M. Guttadauria;E. Cathcart;E. Cathcart;S. Kaplan;S. Kaplan;J. Halla;J. Halla;A. Weinstein;A. Weinstein;P. Plotz
225例活动性严重类风湿性关节炎患者参加了一项多临床、对照、双盲试验，比较了每日500 mg D-青霉胺、每日125 mg D-青霉胺和安慰剂的使用。171例患者完成了至少30周的治疗。与安慰剂组相比，500 mg D-青霉胺组在握力、肿胀近端指间关节平均周长和患者评估方面表现出统计学显著性改善。虽然趋势是随着D-青霉胺剂量的增加而改善更大，但3组之间在晨僵持续时间、步行时间、医生评估、肿胀关节数量或压痛和肿胀关节评分方面没有统计学显著差异。较高剂量D-青霉胺的疗效略有增加与毒性增加有关。
Two hundred twenty-five patients with active severe rheumatoid arthritis were admitted to a multiclinic, controlled, double-blind trial comparing the use of 500 mg D-penicillamine per day, 125 mg D-penicillamine per day, and placebo. One hundred seventy-one patients completed at least 30 weeks of therapy. The 500 mg D-penicillamine group demonstrated statistically significant improvement over the placebo group in grip strength, average circumference of swollen proximal interphalangeal joints, and patient assessment. While the trend was for greater improvement with the larger dose of D-penicillamine, there was no statistically significant difference among the 3 groups in duration of morning stiffness, walking time, physician's assessment, number of swollen joints, or scores for tender and swollen joints. The slight increase in efficacy of higher dose D-penicillamine was associated with increased toxicity.