STUDIES OF D-PENICILLAMINE AND HYDROXYCHLOROQUINE USED IN COMBINATION IN THE TREATMENT OF RHEUMATOID-ARTHRITIS

A preliminary 48-week study of D-penicillamine (DPA) (500mg/day) and hydroxychloroquine (HCQ) (200mg b.i.d.) used in combination to treat 15 patients with active rheumatoid arthritis (RA) produced significant improvement in clinical and laboratory indices of disease activity suggesting marked second-line action. In addition 30 RA patients uncontrolled on DPA were randomly allocated to receive either an increase of 250mg/day of DPA dose or the addition of HCQ (200mg/day). Significant improvement was again seen in clinical and laboratory indices of disease activity over a 24-week treatment period. Side effects were infrequent and not serious. The data suggest that DPA plus HCQ represents an option worthy of further investigation in the treatment of RA.