Successful treatment of methotrexate induced nodulosis with D-penicillamine

Accelerated nodulosis is a recognized complication of methotrexate (MTX) therapy in rheumatoid arthritis (RA). We describe 3 patients with accelerated nodulosis treated with D-penicillamine (D-Pen) while continuing MTX. The combination of D-Pen with MTX therapy resulted in regression of subcutaneous...

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Bibliographic Details
Published inJournal of rheumatology Vol. 26; no. 6; p. 1396
Main Authors Dash, S, Seibold, J R, Tiku, M L
Format Journal Article
LanguageEnglish
Published Canada 01.06.1999
Subjects
Aged
Antirheumatic Agents - adverse effects
Antirheumatic Agents - therapeutic use
Arthritis, Rheumatoid - drug therapy
Female
Humans
Methotrexate - adverse effects
Middle Aged
Penicillamine - therapeutic use
Remission Induction
Rheumatoid Nodule - chemically induced
Rheumatoid Nodule - drug therapy
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Summary:Accelerated nodulosis is a recognized complication of methotrexate (MTX) therapy in rheumatoid arthritis (RA). We describe 3 patients with accelerated nodulosis treated with D-penicillamine (D-Pen) while continuing MTX. The combination of D-Pen with MTX therapy resulted in regression of subcutaneous nodules in all patients, disappearance of pulmonary nodules in one patient, and resolution of vasculitic lesions in 2 patients. Clinical response was observed within the first few weeks of therapy and usually required moderate doses (500 mg/day). Our observations suggest that addition of D-Pen to MTX therapy can be an alternative therapeutic option for accelerated nodulosis in patients with RA.
ISSN:0315-162X