{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T08:43:45Z","timestamp":1785228225260,"version":"3.55.0"},"reference-count":32,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2014,1,21]],"date-time":"2014-01-21T00:00:00Z","timestamp":1390262400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Euro J of Neurology"],"published-print":{"date-parts":[[2014,4]]},"abstract":"<jats:sec><jats:title>Background and purpose<\/jats:title><jats:p>To compare the course of treatment in patients with symptomatic Wilson's disease (<jats:styled-content style=\"fixed-case\">WD<\/jats:styled-content>) receiving either D\u2010penicillamine (<jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content>) or zinc sulfate (<jats:styled-content style=\"fixed-case\">ZS<\/jats:styled-content>) as first\u2010line therapy.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In all, 143 consecutive patients diagnosed with symptomatic <jats:styled-content style=\"fixed-case\">WD<\/jats:styled-content> from January 2005 to December 2009, followed until December 2010, were included. The decision about first\u2010line therapy was made individually after discussion with the patient. Physicians had no clear preference of one drug over the other. Data were analyzed in subgroups with predominantly neurological (<jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content>, 35; <jats:styled-content style=\"fixed-case\">ZS<\/jats:styled-content>, 21) and hepatic (<jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content>, 36; <jats:styled-content style=\"fixed-case\">ZS<\/jats:styled-content>, 51) presentation of <jats:styled-content style=\"fixed-case\">WD<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>According to Kaplan\u2013Meier analysis, neurological <jats:styled-content style=\"fixed-case\">WD<\/jats:styled-content> patients scheduled for <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> had a similar probability of not remaining on first\u2010line therapy as patients receiving <jats:styled-content style=\"fixed-case\">ZS<\/jats:styled-content> (20% vs. 24% at the end of follow\u2010up), with adjusted odds ratio (<jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content>) of 0.9 (95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.2\u20133.5). In patients with hepatic <jats:styled-content style=\"fixed-case\">WD<\/jats:styled-content>, this probability was significantly higher for <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> (31% vs. 12%; adjusted <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 3.0, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.9\u20139.9), especially in the first 6\u00a0months. Early worsening occurred only in neurological <jats:styled-content style=\"fixed-case\">WD<\/jats:styled-content> patients, with no differences between both treatment groups (35% vs. 19%; <jats:styled-content style=\"fixed-case\">OR<\/jats:styled-content> 2.8, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 0.7\u201310.8). Neurological improvement and decrease of liver enzymes were achieved with similar frequency. Compliance with <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> was better in hepatic (97% vs. 80%) but not in neurological patients (91% vs. 81%). Drug adverse effects were more common on <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> (15% vs. 3%).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p><jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> and <jats:styled-content style=\"fixed-case\">ZS<\/jats:styled-content> are effective in the majority of <jats:styled-content style=\"fixed-case\">WD<\/jats:styled-content> patients. Neither therapy appears to be clearly superior. Therefore <jats:styled-content style=\"fixed-case\">ZS<\/jats:styled-content> may be considered a reasonable alternative to <jats:styled-content style=\"fixed-case\">DPA<\/jats:styled-content> as a first\u2010line therapy.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ene.12348","type":"journal-article","created":{"date-parts":[[2014,1,22]],"date-time":"2014-01-22T04:59:08Z","timestamp":1390366748000},"page":"599-606","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":124,"title":["D\u2010penicillamine versus zinc sulfate as first\u2010line therapy for Wilson's disease"],"prefix":"10.1111","volume":"21","author":[{"given":"A.","family":"Cz\u0142onkowska","sequence":"first","affiliation":[{"name":"Second Department of Neurology Institute of Psychiatry and Neurology Warsaw Poland"},{"name":"Department of Experimental and Clinical Pharmacology Medical University Warsaw 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