Whether D-penicillamine and bucillamine are approved DMARDs?

D-penicillamine, a chelating drug indicated for the treatment of Wilson’s disease, has been used as a DMARD for more than 5 to 6 decades. Bucillamine is an approved DMARD in Japan and Korea. D-penicillamine was one of the commonly used DMARDs in late 1900s and 2000s. The literature published in 1998 shows that, though there was no consensus, auranofin, HCQ, minocycline, and SSZ were used to treat early and mild RA, based on the toxicity data available during that time. Whereas, azathioprine, d-penicillamine, methotrexate and parenteral gold were used for managing progressive disease. More toxic agents, such as chlorambucil and cyclophosphamide, were reserved for life-threatening manifestations such as vasculitis (Jackson CG and Williams HJ 1998; Riise T et al. 2001) Although, D-penicillamine is currently available in India; it is prescribed by very few rheumatologists. Bucillamine is not used in any other countries, except Japan and Korea.

1. Jackson CG and Williams HJ. Disease-modifying antirheumatic drugs. Using their clinical pharmacological effects as a guide to their selection. Drugs, 1998. 56(3): p. 337-44.
2. Riise T, Jacobsen BK, and Gran JT. Changes in therapy of rheumatoid arthritis during the period 1979 to 1996. Scand J Rheumatol, 2001. 30(4): p. 199-202. 


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