Comparison of the Effect of Plasmapheresis and Penicillamine on the Level of Circulating Rheumatoid Factor

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Abstract
Plasmapheresis and penicillamine administration resulted in a fall in the level of rheumatoid factor (RF), but this was prompt and transient after plasmapheresis and slow in onset and more lasting in duration after penicillamine. It is suggested that the drug is not exerting its effect on RF by sulfhydryl dissociation of the macroglobulin within the vascular compartment. Other mechanisms postulated are: dissociation of tissue RF, inhibition of production of RF (perhaps by an anti-vitamin B6 action of penicillamine), or a more basic effect on the underlying disease process which is then reflected by a secondary decrease in the titre. There appeared to be a favourable clinical change associated with prolonged drug administration which merits a larger clinical trial.