Treatment of systemic sclerosis with D-penicillamine. A new method of observing the effects of treatment.

A retrospective randomly selected cohort study of D-penicillamine treatment in rapidly progressive diffuse cutaneous systemic sclerosis of recent onset

“…Organ‐specific therapies have substantially decreased the morbidity and mortality of the disease; however, there is a general agreement that effective disease‐modifying therapy is not available. D‐penicillamine has been extensively studied in numerous retrospective studies as well as in a single double‐blind placebo‐controlled clinical trial 6–8,22–28 . Most retrospective studies have suggested that in selected populations of patients with systemic sclerosis, this agent causes improvement in skin involvement and reduction in mortality and organ‐specific morbidity 6,7,22–28 .…”

High-dose versus low-dose D-penicillamine in early diffuse systemic sclerosis: Analysis of a two-year, double-blind, randomized, controlled clinical trial

“…Since 1966, numerous studies reported the clinical usefulness of D-Pen in treating SSc (1)(2)(3)(4)(5)(6)(7)(8)(9)(10)(11)(12). These studies were all uncontrolled and employed diverse dosages, durations of therapy, types of patients enrolled, and measures of efficacy.…”

Penicillamine in the treatment of systemic sclerosis

“…Based on this observation the authors suggested that DPA might be useful in patients with scleroderma (systemic sclerosis or SSc), whose course is characterized by excessive collagen in the skin and internal organs. Numerous reports followed about the results of treating the thickened skin and visceral dysfunction of SSc with DPA with varying results [2][3][4][5][6][7][8][9][10][11]. These studies were all uncontrolled; employed diverse dosages of DPA, durations of SSc prior to entry, durations of DPA therapy, types of patients enrolled and measures of efficacy; and rarely provided statistical analysis.…”