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

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 occurrmng 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.

Sulfasalazine in early rheumatoid arthritis. A 48‐week double‐blind, prospective, placebo‐controlled study

“…As many as 58% of patients may experience at least one adverse effect, although in only 20-25% of patients will treatment be discontinued (43). In a retrospective survey of the adverse effects of SSZ in 774 RA patients, Amos and coworkers (50) stated that the adverse effects are generally seen within 3 months of the initiation of treatment. Allergic hypersensitivity rashes appear in about 5% of patients, while hepatic and hematologic side effects which necessitate discontinuation of the treatment are very rare (43).…”

Methotrexate: an option for preventing the recurrence of acute anterior uveitis

“…For SSZ, 2-3 g per day are typically required to achieve efficacy, and more than 3 g per day often produces adverse events. 13 MTX suppresses disease activity in patients with rheumatoid arthritis in whom other therapies have failed. 14 As mentioned before, MTX has demonstrated efficacy in patients with more severe forms of uveitis.…”

Cutaneous Reactions to Alimentary Tract Medications: Results of a Seven-Year Surveillance Program and Review of the Literature

“…Cutaneous adverse reactions are fre quently reported in association with sulphasalazine includ ing exanthema [44. 45], oral ulcers [45]. and unusual man ifestations such as acute exanthematous pustulosis [46], disturbance of taste |47], induction of lupus erythematosus [48,49], granulomatous lesions [50] and lichen planus-like eruptions [51 ].…”