Objective :
@EN In order to compare the clinical effect and frequency of side effects between d-penicillamine and bucillamine, a chemical derivative of d-penicillamine, we conducted a randomized, controlled clinical trial.
@ES Methods :
@EN22 and 24 patient were allocated in each treatment arm, after stratification according to functional class, anatomical stage, and concomittant steroid use. We evaluated tender joint count, swollen joint count, tenderness score, duration of
morning
stiffness, and grip strength every 4 weeks. Westergren ESR, hemoglobin, leucocyte and platelet count were also checked every 4 weeks, and C-reactive protein (CRP0 quantitation and rheumatoid factor (RF) titration were checked at vaseline and 16
weeks.
Study period spanned 16 weeks.
@ES Results :
@EN At the end of the trial, both swollen joint count and tenderness score decreased signkificantly from baseline in both groups, whereas tender joint count decreased siginficantly in bucillamine-treated group only. Grip strength also improved
significantly bucillamine group. Duration of morning stiffness decreased in both groups. When we arbitrarily defined respones as more than 30% decrease in both tender and swollenjoint count from bseline, 27% of bucillamine group and 33% of
d-penicillamine group responded. The response rate did not differ significantly between the 2 groups. ESR and RF decreased in both groups, whereas CRP decreased significantly only in bucillamine group. The frequency of side effects lasting more
than 1
day and possibly related to drug was 14% and 37% in bucilamine and d-penicillamine group, respectively. The difference was statistically not significant.
@ES Conclusion :
@EN Bucillamine is as effective as d-penicillamine in the treatment of rheumatoid arthritis. The frequency of side effect tended to be lower.
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