Sörensen H
Abteilung für innere Medizin und Rheumatologie, Immanuel-Krankenhaus, Berlin.
Z Rheumatol. 1988;47 Suppl 1:13-6.
The present paper reviews the different therapeutic uses of D-penicillamine and outlines the dosage regimen of D-penicillamine for treatment of rheumatoid arthritis. While many open clinical trials are published, only a few controlled, double-blind studies investigate the "optimal" dosing of D-penicillamine. From these findings, a uniform regimen cannot be named but the heterogenous appearance of chronic polyarthritis requires an individual therapy. In order to minimize the risk of side effects, however, it is necessary to follow the guideline "go low--go slow" as postulated by Jaffe.
本文综述了D-青霉胺的不同治疗用途，并概述了其治疗类风湿性关节炎的给药方案。虽然已发表了许多开放性临床试验，但仅有少数对照双盲研究对D-青霉胺的“最佳”剂量进行了探究。基于这些研究结果，虽无法确定统一的给药方案，但慢性多关节炎的异质性表现需要个体化治疗。然而，为了将副作用风险降至最低，有必要遵循贾菲提出的“从小剂量开始，缓慢增加剂量”的指导原则。
