Penicillamine for Treatment of Rheumatoid Arthritis

A MULTICENTER trial of penicillamine for treatment of rheumatoid arthritis, conducted in the United Kingdom, produced results sufficiently encouraging to induce the Committee on the Safety of Medicines in England to add this disorder to the list of approved indications for penicillamine.1The trial seemed to confirm what various anecdotal reports2,3had already suggested: patients responding poorly to other measures often respond favorably to penicillamine. As a result of these experiences, penicillamine is not only being used more widely, but is currently being tried for patients with earlier, less debilitating, disease.4Despite the fact that the first major work with this drug was done in the United States, there has been little advocacy of this form of treatment here. The cause or causes of rheumatoid arthritis remain unknown, and the reasons for the exuberant and self-propagating inflammatory response are likewise mysterious. Therapeutic efforts must perforce be directed