Efficacy and Toxicity of d‐Penicillamine for Rheumatoid Disease in the Elderly
Efficacy and Toxicity of d‐Penicillamine for Rheumatoid Disease in the Elderly
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d-青霉胺治疗老年类风湿病的疗效和毒性
DOI：
10.1111/j.1532-5415.1982.tb01281.x
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发表时间：
1982
影响因子：
6.3
通讯作者：
C. Dok
中科院分区：
文献类型：
--
作者：
W. Kean;T. Anastassiades;I. Dwosh;P. Ford;W. G. Kelly;C. Dok
在 1975 年 4 月至 1979 年 3 月期间随访的类风湿病患者中研究了 d-青霉胺的疗效和毒性模式。患者群体分为老年组（≥60 岁，平均 = 65 岁）和年轻组（<60 岁，平均 = 41 岁）。患有对非类固醇药物无反应的典型或明确类风湿病的患者符合资格。 d-青霉胺治疗前的平均疾病持续时间在老年人中为 5 年，在年轻组中为 7 年。总体而言，平均随访时间为 11 个月。老年人 D-青霉胺的平均剂量为 461 毫克/天，年轻患者为 520 毫克/天。结果表明，d-青霉胺在三个月后的所有时间段内对 75% 的老年人有效，对 75% 的年轻患者在三个月后至至少两年内有效。先前的金盐治疗不影响疗效。老年人中总体皮疹（P < 0.01）、严重皮疹（P < 0.01）和味觉能力明显异常（P < 0.05）的毒性明显更大。与年轻患者相比，老年患者的血液学毒性发生率并未增加。两组的毒性均不受先前金盐治疗的影响。结论是，d-青霉胺对老年人和年轻人同样有效，并且毒性模式相似，除了老年人出现皮疹和味觉异常的倾向增加之外。
The efficacy and the toxicity pattern of d‐penicillamine were studied in patients with rheumatoid disease followed up between April 1975 and March 1979. The population of patients was divided into an elderly group (≥60 years old, mean = 65 years) and a younger group (<60 years old, mean = 41 years). Patients with classic or definite rheumatoid disease not responsive to nonsteroidal drugs were eligible. The mean durations of disease prior to d‐penicillamine therapy were five years in the elderly and seven years in the younger group. Overall, the mean follow‐up time was 11 months. The average dosages of d‐penicillamine were 461 mg/day in the elderly and 520 mg/day in the younger patients. Results indicated that d‐penicillamine was efficacious in 75 per cent of the elderly during all time periods after three months, and in 75 per cent of the younger patients after three months until at least two years. Prior gold‐salt therapy did not influence efficacy. Toxicity was significantly greater in the elderly for overall skin rash (P < 0.01), severe skin rash (P < 0.01), and marked abnormalities in the ability to taste (P < 0.05). The incidence of hematologic toxicity was not increased in the elderly compared with the younger patients. Toxicity in either group was not influenced by prior gold‐salt therapy. It is concluded that d‐penicillamine was equally efficacious in both elderly and younger groups, and that the toxicity patterns were similar except for increased tendencies toward rashes and taste abnormalities in the elderly.