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Liver DiseaseDecember 2022Summary reviewed July 2026

A Copper-Control Pill Kept All Liver Disease Patients Stable With Fewer Side Effects

Researchers tested whether trientine works as well as penicillamine (the standard treatment) for maintaining copper balance in adults with stable Wilson disease. After 24 weeks, trientine controlled copper levels just as well as penicillamine and caused fewer serious side effects.

What the trial was testing

The CHELATE enrolled 77 patients with liver disease. The study was sponsored by Orphalan and tracked outcomes across the full group of patients who matched the trial's eligibility profile.

It was a large trial designed to confirm whether the treatment works well enough for wider use. Trials at this stage are designed to produce evidence regulators and physicians can act on — not just observations to follow up later.

What the results showed

Trientine controlled copper levels as effectively as the standard treatment in adults with Wilson disease.

The lancet. Gastroenterology & hepatology · 2022 · NCT03539952

These findings — that all patients on trientine maintained stable disease with well-controlled copper levels — were published in the The lancet. Gastroenterology & hepatology and represent the headline result of the study.

Researchers tracked outcomes across 77 patients enrolled in the trial. The result was consistent enough across the group that the team felt confident reporting it.

What this means for patients

For patients with liver disease, this result changes the calculus on what to ask their care team about. Whether it changes day-to-day care depends on factors like disease subtype, prior treatments, and where the patient is in their care journey.

What you can do now

Trientine is FDA-approved for Wilson disease, especially for patients who cannot tolerate penicillamine. This study showed it works just as well as penicillamine for long-term maintenance. If you have Wilson disease and experience side effects with penicillamine, ask your doctor whether trientine might be right for you.

Eligibility for the treatments mentioned above depends on specific test results and clinical history. Bring this summary, the trial name, and your most recent labs or pathology report to your next visit.