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Treatment of the Neurologic Manifestations of Wilson's Disease-Reply

Treatment of the Neurologic Manifestations of Wilson's Disease-Reply Abstract In reply The main point of the letter by Scheinberg and Sternlieb seems to be that penicillamine is an excellent therapy most of the time for patients with Wilson's disease who present with neurologic disease and, when it is not, injections with British anti-Lewisite are often helpful. The apparent implication is that, in their hands, problems with initial therapy are so few that development of an additional agent for this purpose, such as the tetrathiomolybdate therapy that we reported,1 is not worthwhile.The major problem with the assertions of Scheinberg and Sternlieb is that they are based on the notoriously inaccurate "clinical impression" rather than on rigorously established scientific fact. For example, they say that for 35 years "ourselves, or as consultants to other physicians, have prescribed initial treatment with penicillamine for hundreds of patients." Specifically, how many patients is "hundreds"?A scientific study would not say "hundreds," but would References 1. Brewer GJ, Dick RD, Johnson V, et al. Treatment of Wilson's disease with tetrathiomolybdate . Arch Neurol . 1994;51:545-554.Crossref 2. Brewer GJ, Terry CA, Aisen AM, Hill GM. Worsening of neurological syndrome in patients with Wilson's disease with initial penicillamine therapy . Arch Neurol . 1987;44:490-494.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Archives of Neurology American Medical Association

Treatment of the Neurologic Manifestations of Wilson's Disease-Reply

Archives of Neurology , Volume 52 (4) – Apr 1, 1995

Treatment of the Neurologic Manifestations of Wilson's Disease-Reply

Abstract

Abstract In reply The main point of the letter by Scheinberg and Sternlieb seems to be that penicillamine is an excellent therapy most of the time for patients with Wilson's disease who present with neurologic disease and, when it is not, injections with British anti-Lewisite are often helpful. The apparent implication is that, in their hands, problems with initial therapy are so few that development of an additional agent for this purpose, such as the tetrathiomolybdate therapy that we...
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Publisher
American Medical Association
Copyright
Copyright © 1995 American Medical Association. All Rights Reserved.
ISSN
0003-9942
eISSN
1538-3687
DOI
10.1001/archneur.1995.00540280019008
Publisher site
See Article on Publisher Site

Abstract

Abstract In reply The main point of the letter by Scheinberg and Sternlieb seems to be that penicillamine is an excellent therapy most of the time for patients with Wilson's disease who present with neurologic disease and, when it is not, injections with British anti-Lewisite are often helpful. The apparent implication is that, in their hands, problems with initial therapy are so few that development of an additional agent for this purpose, such as the tetrathiomolybdate therapy that we reported,1 is not worthwhile.The major problem with the assertions of Scheinberg and Sternlieb is that they are based on the notoriously inaccurate "clinical impression" rather than on rigorously established scientific fact. For example, they say that for 35 years "ourselves, or as consultants to other physicians, have prescribed initial treatment with penicillamine for hundreds of patients." Specifically, how many patients is "hundreds"?A scientific study would not say "hundreds," but would References 1. Brewer GJ, Dick RD, Johnson V, et al. Treatment of Wilson's disease with tetrathiomolybdate . Arch Neurol . 1994;51:545-554.Crossref 2. Brewer GJ, Terry CA, Aisen AM, Hill GM. Worsening of neurological syndrome in patients with Wilson's disease with initial penicillamine therapy . Arch Neurol . 1987;44:490-494.Crossref

Journal

Archives of NeurologyAmerican Medical Association

Published: Apr 1, 1995

References