Moens H J, Ament B J, Feltkamp B W, van der Korst J K
Jan van Breemen Institute, Amsterdam, The Netherlands.
J Rheumatol. 1987 Dec;14(6):1115-9.
To assess therapeutic effect and toxicity of D-penicillamine in relation to HLA antigens, 111 consecutive patients with rheumatoid arthritis (RA) were followed for a period of 7-9 years. Side effects occurred in 60% and were the main reason for withdrawal in 52%. HLA typing was performed in 86; overall frequencies were comparable with those found in other studies in patients with RA. Drug induced proteinuria (5 patients) was associated with HLA-B8/DR3 (60 vs 9%), and thrombocytopenia (23 patients) with HLA-DR4 (94 vs 67%). Therapeutic effect was good in 26 (23%), and moderate in 30 (27%). No single variable, including HLA antigens, was predictive of effectiveness. It is concluded that although some of the side effects were associated with HLA antigens, HLA typing is not useful in predicting the outcome of treatment with D-penicillamine.
为评估青霉胺治疗类风湿关节炎（RA）的疗效及毒性与HLA抗原的关系，对111例连续的类风湿关节炎患者进行了7至9年的随访。60%的患者出现了副作用，其中52%的患者因副作用而停药。对86例患者进行了HLA分型；总体频率与其他类风湿关节炎患者研究中的频率相当。药物性蛋白尿（5例患者）与HLA - B8/DR3相关（60%对9%），血小板减少症（23例患者）与HLA - DR4相关（94%对67%）。26例（23%）患者治疗效果良好，30例（27%）患者治疗效果中等。没有单一变量，包括HLA抗原，能够预测疗效。结论是，虽然某些副作用与HLA抗原相关，但HLA分型对于预测青霉胺治疗的结果并无帮助。
