Prospective trial of penicillamine in primary sclerosing cholangitis

Nicholas F La Russo, Russell H. Wiesner, Jurgen Ludwig, Robert L. MacCarty, Sandra J. Beaver, Alan R. Zinsmeister

Research output: Contribution to journalArticle

141 Citations (Scopus)

Abstract

We evaluated the therapeutic efficacy of penicillamine in primary sclerosing cholangitis. In a randomized, prospective, double-blind trial, 39 patients received penicillamine (250 mg t.i.d.) and 31 received a placebo. The two groups were highly comparable at entry with regard to clinical, biochemical, radiologic, and hepatic histologic features. Although a predictable cupruresis and a decrease in levels of hepatic copper were achieved in patients taking penicillamine, there was no beneficial effect on disease progression within 36 mo or on overall survival. Progressive symptoms, deterioration in serial hepatic laboratory values, or histologic progression on sequential liver biopsy specimens were similar in both groups, occurring in >80% of the entire study population. The development of major side effects led to the permanent discontinuation of penicillamine in 21% of the patients taking the drug. We conclude that the use of penicillamine in primary sclerosing cholangitis is not associated with a beneficial effect on disease progression or survival, and has considerable toxicity. The study also suggests that primary sclerosing cholangitis is a progressive disease in many patients.

Original languageEnglish (US)
Pages (from-to)1036-1042
Number of pages7
JournalGastroenterology
Volume95
Issue number4
StatePublished - 1988

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Sclerosing Cholangitis
Penicillamine
Liver
Disease Progression
Survival
Copper
Placebos
Biopsy
Pharmaceutical Preparations
Population

ASJC Scopus subject areas

  • Gastroenterology

Cite this

La Russo, N. F., Wiesner, R. H., Ludwig, J., MacCarty, R. L., Beaver, S. J., & Zinsmeister, A. R. (1988). Prospective trial of penicillamine in primary sclerosing cholangitis. Gastroenterology, 95(4), 1036-1042.

Prospective trial of penicillamine in primary sclerosing cholangitis. / La Russo, Nicholas F; Wiesner, Russell H.; Ludwig, Jurgen; MacCarty, Robert L.; Beaver, Sandra J.; Zinsmeister, Alan R.

In: Gastroenterology, Vol. 95, No. 4, 1988, p. 1036-1042.

Research output: Contribution to journalArticle

La Russo, NF, Wiesner, RH, Ludwig, J, MacCarty, RL, Beaver, SJ & Zinsmeister, AR 1988, 'Prospective trial of penicillamine in primary sclerosing cholangitis', Gastroenterology, vol. 95, no. 4, pp. 1036-1042.
La Russo NF, Wiesner RH, Ludwig J, MacCarty RL, Beaver SJ, Zinsmeister AR. Prospective trial of penicillamine in primary sclerosing cholangitis. Gastroenterology. 1988;95(4):1036-1042.
La Russo, Nicholas F ; Wiesner, Russell H. ; Ludwig, Jurgen ; MacCarty, Robert L. ; Beaver, Sandra J. ; Zinsmeister, Alan R. / Prospective trial of penicillamine in primary sclerosing cholangitis. In: Gastroenterology. 1988 ; Vol. 95, No. 4. pp. 1036-1042.
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