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British Medical Journal (Clinical Research Ed.) logoLink to British Medical Journal (Clinical Research Ed.)
. 1986 Aug 16;293(6544):420–423. doi: 10.1136/bmj.293.6544.420

Sulphasalazine for rheumatoid arthritis: toxicity in 774 patients monitored for one to 11 years.

R S Amos, T Pullar, D E Bax, D Situnayake, H A Capell, B McConkey
PMCID: PMC1341237  PMID: 2874863

Abstract

Sulphasalazine is being used increasingly to treat rheumatoid arthritis, though its long term safety profile has not been established in this condition. The incidence and nature of adverse effects occurring in 774 patients with rheumatoid arthritis treated with sulphasalazine for periods ranging from one to 11 years were therefore noted. Altogether 205 of the patients stopped treatment permanently due to an adverse effect. One hundred and fifty six (76%) of these events occurred within three months and few beyond the first year. Most events were trivial and were self limiting after withdrawal of the drug; of the potentially more serious adverse effects, 33 (66%) occurred within three months of treatment. None of the patients died or suffered lasting ill effects. It is concluded that adverse effects of treatment with sulphasalazine are generally seen within three months; though regular monitoring is desirable during that period, thereafter few worrying problems occur.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bax D. E., Amos R. S. Sulphasalazine in rheumatoid arthritis: desensitising the patient with a skin rash. Ann Rheum Dis. 1986 Feb;45(2):139–140. doi: 10.1136/ard.45.2.139. [DOI] [PMC free article] [PubMed] [Google Scholar]
  2. Bax D. E., Amos R. S. Sulphasalazine: a safe, effective agent for prolonged control of rheumatoid arthritis. A comparison with sodium aurothiomalate. Ann Rheum Dis. 1985 Mar;44(3):194–198. doi: 10.1136/ard.44.3.194. [DOI] [PMC free article] [PubMed] [Google Scholar]
  3. Berliner S., Neeman A., Shoenfeld Y., Eldar M., Rousso I., Kadish U., Pinkhas J. Salazopyrin-induced eosinophilic pneumonia. Respiration. 1980;39(2):119–120. doi: 10.1159/000194205. [DOI] [PubMed] [Google Scholar]
  4. Chester A. C., Diamond L. H., Schreiner G. E. Hypersensitivity to salicylazosulfapyridine: renal and hepatic toxic reactions. Arch Intern Med. 1978 Jul;138(7):1138–1139. doi: 10.1001/archinte.138.7.1138. [DOI] [PubMed] [Google Scholar]
  5. Davies D., MacFarlane A. Fibrosing alveolitis and treatment with sulphasalazine. Gut. 1974 Mar;15(3):185–188. doi: 10.1136/gut.15.3.185. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. GOUGH K. R., MCCARTHY C., READ A. E., MOLLIN D. L., WATERS A. H. FOLIC-ACID DEFICIENCY IN RHEUMATOID ARTHRITIS. Br Med J. 1964 Jan 25;1(5377):212–217. doi: 10.1136/bmj.1.5377.212. [DOI] [PMC free article] [PubMed] [Google Scholar]
  7. Grindulis K. A., McConkey B. Does sulphasalazine cause folate deficiency in rheumatoid arthritis? Scand J Rheumatol. 1985;14(3):265–270. doi: 10.3109/03009748509100404. [DOI] [PubMed] [Google Scholar]
  8. Jones G. R., Malone D. N. Sulphasalazine induced lung disease. Thorax. 1972 Nov;27(6):713–717. doi: 10.1136/thx.27.6.713. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Martin L., Sitar D. S., Chalmers I. M., Hunter T. Sulfasalazine in severe rheumatoid arthritis: a study to assess potential correlates of efficacy and toxicity. J Rheumatol. 1985 Apr;12(2):270–273. [PubMed] [Google Scholar]
  10. Mihas A. A., Goldenberg D. J., Slaughter R. L. Sulfasalazine toxic reactions. Hepatitis, fever, and skin rash with hypocomplementemia and immune complexes. JAMA. 1978 Jun 16;239(24):2590–2591. doi: 10.1001/jama.239.24.2590. [DOI] [PubMed] [Google Scholar]
  11. PARTRIDGE R. E., DUTHIE J. J. Incidence of macrocytic anaemia in rheumatoid arthritis. Br Med J. 1963 Jan 12;1(5323):89–91. doi: 10.1136/bmj.1.5323.89. [DOI] [PMC free article] [PubMed] [Google Scholar]
  12. Pullar T., Hunter J. A., Capell H. A. Which component of sulphasalazine is active in rheumatoid arthritis? Br Med J (Clin Res Ed) 1985 May 25;290(6481):1535–1538. doi: 10.1136/bmj.290.6481.1535. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Schneider R. E., Beeley L. Megaloblastic anaemia associated with sulphasalazine treatment. Br Med J. 1977 Jun 25;1(6077):1638–1639. doi: 10.1136/bmj.1.6077.1638. [DOI] [PMC free article] [PubMed] [Google Scholar]
  14. Situnayake R. D., McConkey B. Resin-coated 5-aminosalicylic acid (Asacol) in rheumatoid arthritis. Br J Rheumatol. 1985 May;24(2):226–227. doi: 10.1093/rheumatology/24.2.226. [DOI] [PubMed] [Google Scholar]

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