Rethinking Zinc as First-Line Therapy for Wilson Disease

Wilson disease (WD), although rare, is associated with significant morbidity and mortality if untreated. The mainstay of initial therapy is copper chelation with agents such as D-penicillamine and trientene. A previous study suggested that zinc monotherapy was effective in patients with mainly neurological symptoms or asymptomatic hepatic disease (JW Gastroenterol Jan 8 2010). However, that study was a small case series without a comparison group.

Now, in a larger study, European researchers have compared the long-term effectiveness of zinc monotherapy with that of chelating agents by retrospectively assessing initial symptoms, treatment regimens, and outcomes in 288 patients during a median follow-up of 17.1 years. Median age at onset of di…