D-PENICILLAMINE INDUCED TOXICITY IN RHEUMATOID-ARTHRITIS - THE ROLE OF SULFOXIDATION STATUS AND HLA-DR3

  • 1 January 1984
    • journal article
    • research article
    • Vol. 11  (5) , 626-632
Abstract
Sulfoxidation of carbocysteine, a drug structurally similar to D-penicillamine, displays a skewed distibution within a population. In 66 patients with rheumatoid arthritis (RA), a significant association between impaired sulfoxidation and toxicity (P < 0.001) was found; HLA-DR3, although associated with toxicity (P < 0.05), appeared to be an independent risk factor of most importance in the group with extensive sulfoxidation. The relative risk of toxicity in a patient possessing either DR3 or impaired sulfoxidation was 25. The prevalence of poor sulfoxidizers within this group of RA patients was increased compared to that in a previous population study and requires further investigation. Findings explain a number of the toxic phenomena associated with D-penicillamine administration in RA.