Trientine resistance treatment

Trientine (Trientine) is a chelating agent used to treat Wilson's disease. Its main function is to reduce the toxic accumulation of copper in the body by binding to excess copper ions in the body and promoting their excretion through urine. However, current research and clinical experience regarding trientine resistance are relatively limited. Nonetheless, clinicians often respond to situations where resistance or intolerance may arise, using a range of strategies.

First, the definition of drug resistance needs to be clear. In the current literature, resistance to trientine refers more to patients' poor response to its treatment or adverse reactions, rather than drug resistance in the traditional sense. Therefore, if a patient experiences a decrease in efficacy after long-term use of trientine, doctors will usually first evaluate whether the patient has strictly complied with the medication instructions, including dosage, medication time, and dietary control. The management of Wilson's disease requires strict control of dietary copper intake. If the patient's copper intake is too high, the efficacy of trientine may be affected.

Secondly, if it is confirmed that the patient does not respond well to trientine treatment, the doctor may consider adjusting the drug dosage. The dose of trientine is usually adjusted based on the patient's weight, severity of illness, and renal function. The dose can be increased appropriately if necessary, but it must be done under close supervision by a doctor to avoid potential side effects, such as gastrointestinal discomfort, anemia, or abnormal liver and kidney function.

In addition, doctors may consider alternative treatment options for patients who do not respond satisfactorily to trientine. Penicillamine is another chelating agent commonly used to treat Wilson's disease, often as an alternative to trientine. However, penicillamine has many side effects, such as rash, blood system abnormalities, etc., so the patient's tolerance needs to be carefully assessed when switching drugs.

Reference materials:https://pubmed.ncbi.nlm.nih.gov/18559222/