Effects of sulfasalazine: A Synthesis of Findings from 12 Studies

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Original Abstract of the Article

Major findings

Sulfasalazine and its metabolites affect the steady state mRNA levels of inflammatory cytokines, matrix metalloproteinases, and tissue inhibitors of metalloproteinase in rheumatoid synovial fibroblasts. 5

A combination of traditional Chinese medicine and Western medicine, which includes sulfasalazine and moxibustion, was significantly more effective than Western medicine alone in treating patients with cold-dampness obstruction type ankylosing spondylitis. 12

Sulfasalazine can cause a variety of side effects.

Sulfasalazine inhibits the formation of lipoxygenase and cyclooxygenase products in human leukocytes. Its analogue, CL 42A, is a more potent inhibitor of lipoxygenase than sulfasalazine. 1

Sulfasalazine attenuates the spontaneous colitis observed in HLA-B27 transgenic rats. 7

Rolapitant, administered intravenously or orally, may affect the pharmacokinetics of digoxin and sulfasalazine in healthy volunteers. 4

Sulfasalazine metabolites inhibit hemoglobin-catalyzed lipid peroxidation. 5-aminosalicylic acid (5-ASA) is a more effective inhibitor of lipid peroxidation than sulfasalazine. 9

Sulfasalazine has favorable effects on small bowel Crohn's disease and is effective in the long-term treatment. 3

Sulfasalazine exhibits immunomodulatory effects on human polymorphonuclear leukocytes, mononuclear cells, and cultured glomerular mesangial cells. Sulfasalazine inhibits phagocytosis in polymorphonuclear neutrophils and proliferation in mononuclear cells. 11

Sulfasalazine treatment was not found to be effective on enthesal abnormalities of inflammatory rheumatic diseases. 8

Sulfasalazine does not quantitatively alter selected lymphocyte subpopulations in vivo or in vitro. 2

Sulfasalazine and its metabolites have different effects on the metabolism of endogenous versus exogenous arachidonic acid. Sulfasalazine may act as an inhibitor of lipoxygenase, phospholipase A2, and LTB4 metabolism. 10

Sulfasalazine and 5-aminosalicylic acid affect sperm-fertilizing capacity and reactive oxygen species generation in men with inflammatory bowel disease, which may contribute to infertility. 6

Benefits and Risks

Benefits Summary

Sulfasalazine may be effective in treating various inflammatory diseases, including rheumatoid arthritis and Crohn's disease. 5 , 3

For treating patients with cold-dampness obstruction type ankylosing spondylitis, a combination of sulfasalazine and moxibustion may be effective. 12

Risks Summary

Sulfasalazine can cause a variety of side effects, including nausea, vomiting, abdominal pain, headache, rash, indigestion, and allergic reactions.

Sulfasalazine may impair sperm function and affect fertility. 6

Comparison between Studies

Commonalities

Many studies suggest that sulfasalazine is effective in treating various inflammatory diseases. 5 , 12 , 3

Some studies indicate that sulfasalazine may cause side effects. , 6

Differences

Different studies suggest varying degrees of effectiveness and side effects of sulfasalazine. 5 , 12 , 3 , , 6

Some studies suggest that sulfasalazine does not improve enthesal abnormalities. 8

Consistency and Contradictions

Sulfasalazine may be effective in treating various inflammatory diseases, but its effectiveness may vary among individuals. 5 , 12 , 3

Sulfasalazine may cause side effects, but the risk may vary among individuals. , 6

Important Notes for Real-Life Application

Sulfasalazine should be taken as directed by a doctor. 5 , 12 , 3 , , 6

Before taking sulfasalazine, consult with a doctor about your current health conditions and medications. 5 , 12 , 3 , , 6

If you experience any side effects while taking sulfasalazine, consult with a doctor. , 6

Limitations of Current Research

Many studies on sulfasalazine are small in scale and short-term in duration. 5 , 12 , 3 , , 6

More research is needed to fully understand the effects and safety of sulfasalazine. 5 , 12 , 3 , , 6

Future Research Directions

Long-term studies are needed to investigate the effects and safety of sulfasalazine over extended periods. 5 , 12 , 3 , , 6

Research is needed to investigate factors that may influence the effects and side effects of sulfasalazine. 5 , 12 , 3 , , 6

Conclusion

Sulfasalazine may be effective in treating inflammatory diseases such as rheumatoid arthritis and Crohn's disease. 5 , 3

It is important to take sulfasalazine as directed by a doctor, as it can cause side effects. , 6

It is recommended to consult with a doctor before taking sulfasalazine. 5 , 12 , 3 , , 6

Literature analysis of 12 papers
Positive Content
9
Neutral Content
2
Negative Content
0
Article Type
0
0
0
0
12
1.

Effects of sulfasalazine and a sulfasalazine analogue on the formation of lipoxygenase and cyclooxygenase products.

Author: TornhamreS, EdeniusC, SmedegårdG, SjöquistB, LindgrenJ A

Leukotriene inhibition

CL 42A, a sulfasalazine analogue, is a potent inhibitor of leukotriene synthesis. Sulfasalazine also inhibits leukotriene formation but is less potent than CL 42A.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

2.

Effects of sulfasalazine on selected lymphocyte subpopulations in vivo and in vitro.

Author: ThayerW R, CharlandC, FieldC E

IBD therapy
Unknown mechanism

Sulfasalazine did not significantly alter the number of circulating T cells, Ig-bearing B cells, or complement receptor-bearing lymphocytes in patients with inflammatory bowel disease.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

4.

Effects of Rolapitant Administered Intravenously or Orally on the Pharmacokinetics of Digoxin (P-glycoprotein Substrate) and Sulfasalazine (Breast Cancer Resistance Protein Substrate) in Healthy Volunteers.

Author: WangXiaodong, ZhangZhi-Yi, AroraSujata, HughesLorraine, WangJing, PowersDaniel, ChristensenJennifer, LuSharon, KansraVikram

Chemotherapy-induced nausea prevention
Drug interactions

Rolapitant is a drug that is used to prevent nausea and vomiting caused by chemotherapy. This study looked at the safety and drug interactions of rolapitant when given intravenously or orally. The study found that rolapitant was safe and well-tolerated, but that it could interact with other drugs.

Clinical Trial, Phase IThe first stage of clinical trials in humans. Evaluates the safety, tolerability, and pharmacokinetics of a new drug/treatment.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

6.

Inflammatory bowel disease and male infertility: effects of sulfasalazine and 5-aminosalicylic acid on sperm-fertilizing capacity and reactive oxygen species generation.

Author: WuF C, AitkenR J, FergusonA

Sperm function improvement
Sperm function impairment

Sulfasalazine can impair sperm function in men with inflammatory bowel disease, but this impairment can be reversed by switching to 5-aminosalicylic acid. This effect is not related to increased reactive oxygen species.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

7.

Effects of nitric oxide synthase inhibition or sulfasalazine on the spontaneous colitis observed in HLA-B27 transgenic rats.

Author: AikoS, FuselerJ, GrishamM B

Improved colitis
Reduced inflammation

Aminoguanidine and NG-nitro-L-arginine methyl ester, but not sulfasalazine, attenuated nitric oxide production and inflammation in HLA-B27 transgenic rats with colitis.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

8.

The effects of sulfasalazine treatment on enthesal abnormalities of inflammatory rheumatic diseases.

Author: GencHakan, Duyur CakitBurcu, NacirBaris, SaracogluMeryem, KacarMahmut, ErdemHatice Rana

Enthesal abnormalities

This study investigated the effects of sulfasalazine monotherapy on enthesal abnormalities in inflammatory rheumatic diseases using ultrasonography. While sulfasalazine improved clinical and laboratory activity, it had no significant impact on enthesal abnormalities.

Clinical TrialA clinical trial is a planned study conducted on humans to evaluate the efficacy and safety of pharmaceuticals, medical devices, and treatment methods. It aims to explore the possibilities of new treatments and improve the health of patients.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.

Language : English

9.

The effects of sulfasalazine metabolites on hemoglobin-catalyzed lipid peroxidation.

Author: YamadaT, VolkmerC, GrishamM B

Anti-inflammatory effect
Inhibition of lipid peroxidation
None mentioned

Sulfasalazine (SAZ) and its metabolite 5-aminosalicylic acid (5-ASA) were tested for their ability to inhibit lipid peroxidation, a process that contributes to inflammation in ulcerative colitis. 5-ASA was significantly better than SAZ at inhibiting lipid peroxidation, suggesting that 5-ASA may play a role in the anti-inflammatory effects of SAZ.

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

10.

A comparison of effects of sulfasalazine and its metabolites on the metabolism of endogenous vs. exogenous arachidonic acid.

Author: AllgayerH, StensonW F

Inhibition of LTB4 metabolism
Inhibition of lipoxygenase
Inhibition of phospholipase A2

Sulfasalazine, and to a lesser extent, 5-aminosalicylic acid and N-acetyl-aminosalicylic acid, were found to inhibit the production of leukotriene B4 (LTB4) in human neutrophils. This suggests that these drugs may have anti-inflammatory effects.

Comparative StudyResearch that compares multiple groups/interventions to determine differences/similarities in outcomes/characteristics.
Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.
Research Support, U.S. Gov't, P.H.S.Research funding provided by the Public Health Service (PHS).

Language : English

11.

The in vitro immunomodulatory effects of sulfasalazine on human polymorphonuclear leukocytes, mononuclear cells, and cultured glomerular mesangial cells.

Author: TsaiC Y, WuT H, YuC L, ChouC T

May treat immune-mediated glomerulonephritis
Minimal nephrotoxicity

Sulfasalazine was found to inhibit phagocytic activity of normal human polymorphonuclear neutrophils (PMN) and proliferation of mononuclear cells (MNC).

Journal ArticleAn article published in an academic or professional journal that reports original research or scholarly analysis.
Research Support, Non-U.S. Gov'tResearch funding provided by government agencies outside the United States.

Language : English

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