Abstract
Current medical management for established hemophilic arthritis is unsatisfactory and does not modify the eventual outcome. D-Penicillamine (PEN), an anti-inflammatory drug effective in rheumatoid arthritis, has not been evaluated in hemarthroses-induced joint disease. 83 NZ white rabbits had weekly intra-articular injections of citrated autologous blood (right knee) and citrated saline (left knee) for 6 months. PEN 15 mg or 50 mg/kg/da, IM, was begun early (day 1) or late (at 8 wks). Controls were saline treated rabbits. The animals were killed at 6 mo. Analysis included joint fluid WBC counts, gross and histologic examination of the synovia (acute and chronic inflammatory cells, synovial hyperplasia, and iron deposition). The saline-injected knees showed no inflammatory change and the blood-injected knees had iron deposition in all animal groups. The early high and low dose, and late low dose PEN treated groups showed no difference from untreated animals. Late high dose PEN treatment showed marked suppression of the synovitis. Four hemophiliacs with synovitis were given PEN, 5-10 mg/kg/da, p.o. for>2 months. All have had significant reduction in the synovial thickening with concurrent increased range-of-motion and decreased number of bleeds into the affected joint. These studies suggest that PEN is beneficial in the chronic arthritis induced by hemarthroses. Its anti-inflammatory mechanism is not known but may be inhibiting free radical formation, not by removing iron by its chelating ability.
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Corrigan, J., Kolba, K., Gall, E. et al. PENICILLAMINE TREATMENT IN HEMATHROSIS-INDUCED CHRONIC ARTHRITIS. Pediatr Res 18 (Suppl 4), 238 (1984). https://doi.org/10.1203/00006450-198404001-00873
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DOI: https://doi.org/10.1203/00006450-198404001-00873