Gene/Protein Disease Symptom Drug Enzyme Compound
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Query: UMLS:C0003873 (rheumatoid arthritis)
 53,068 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Long-term administration of SASP does offer clinical benefit and has a demonstrable disease modifying effect in rheumatoid arthritis, though its mode of action remains obscure. We have studied the in vitro effects of SASP and its metabolites, that is SP, ASA, AcSP and AcASA, on the blast-formation of lymphocytes, the cytotoxic activity of NK cell, the phagocytosis and H2O2 production of monocyte and the fMLP-induced chemotaxis and superoxide anions production of PMNs. We have obtained the following results: (1) the blast-formation of lymphocytes by PHA and Protein A was significantly inhibited by SASP, but not by the metabolites; (2) the cytotoxic activity of the NK cell was inhibited by SP and AcSP, but not by SASP, ASA and AcASA; (3) on monocyte, SP, AcSP and AcASA inhibited phagocytosis, and all of drugs had no effect on the production of H2O2; (4) on PMNs, SASP, SP and ASA significantly inhibited fMLP-induced chemotaxis, and SASP and all of its metabolites significantly inhibited a release of superoxide anions by stimulation of fMLP and PMA; (5) SASP and ASA scavenged superoxide radical at the concentration comparable to clinical doses. In vivo, the above effects may be exhibited in proportion to each blood concentrations of drugs. In particular, it appears that SASP, SP and AcSP play an important role in the therapeutic efficacy in rheumatoid arthritis.
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PMID:[Effect of salazosulfapyridine and its metabolites on immunocompetent cells]. 257 59

Thirty patients with active rheumatoid arthritis (RA) participated in an open study of 6 months' treatment with either 5-aminosalicylic acid (5-ASA) or sulphapyridine (SP), the two moieties of sulphasalazine (SASP). Patients were assessed at regular intervals using clinical and biochemical tests designed to detect specific antirheumatic activity. Patients taking SP showed significant improvement in disease activity, but those taking 5-ASA did not improve, despite the fact that high serum concentrations of 5-ASA and acetyl 5-ASA were achieved. These results suggest that SP is the active moiety of SASP. Its possible mode of action is discussed. Nausea was a frequent problem in patients taking SP. Unless this can be overcome, SP is unlikely to offer any therapeutic advantages over SASP in the treatment of RA.
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PMID:A study to determine the active moiety of sulphasalazine in rheumatoid arthritis. 287 45

The efficiency of sulphasalazine (SASP) as a long-acting antirheumatic drug for rheumatoid arthritis is now well established by placebo-controlled studies and comparative trials with injectable gold and D-penicillamin. Early treatment effect and better tolerance suggest the use of SASP especially for early treatment of rheumatoid arthritis. Severe and advanced disease, in which gold and/or D-penicillamin were not effective or toxic, may also be treated with SASP. Open questions are the effect on the radiological progression and the differential indication to antimalarials, oral gold and methotrexat. Positive results of two placebo-controlled studies in ankylosing spondylitis for the first time open the perspective of a long-acting antiphlogistic therapy in this disease. Further open trials observed promising treatment effects of SASP in reactive and juvenile rheumatoid arthritis. Therefore, future clinical studies have to establish indication, benefit-risk-relation and treatment modalities also in these rheumatic disorders.
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PMID:[Clinical studies with salazopyrine--consequences and perspectives]. 288 85

Twenty-six out-patients with active rheumatoid arthritis (RA) were randomly allocated to treatment with sulphasalazine (SASP) or D-penicillamine (DPA). Faecal samples were collected from all patients at 4-weekly intervals and examined for changes in faecal flora during treatment. Both treatment groups showed substantial clinical improvement. In the SASP-treated group this was accompanied by significant falls in counts of Cl. perfringens and E. coli. No such changes were seen in the DPA-treated group. These results suggest that SASP's efficacy in RA may be related to its antibacterial properties.
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PMID:Effects of sulphasalazine on faecal flora in patients with rheumatoid arthritis: a comparison with penicillamine. 288 1

The SASP was studied in 46 patients with rheumatoid arthritis. The efficacy criteria which were selected (decrease of the sed rate by more than 50 p. cent during the first hour, morning stiffness under 20 minutes, Ritchie's index inferior to 10 and decreased cortisone and NSAID doses), explain that 25 p. cent of the patients are considered as satisfied after 12 months of trial. The patients selected, present severe forms of the disease or forms resistant to other treatments. The improvement appears significant after the first month. Half of the patients left the trial either because of ineffectiveness, or evolutive relapse (21.73 p. cent) or because of side-effects (28.26 p. cent). The most frequently observed disorders and intolerances are of digestive nature. No serious accident is to be deplored. Such results are in accordance with the data from the literature. The SASP must therefore be considered as the fundamental treatment of rheumatoid arthritis. The new galenic forms, dissolving in the gastro-intestinal tract, have enabled to markedly improve the digestive tolerance.
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PMID:[Sulfasalazine or salazosulfapyridine in the treatment of rheumatoid polyarthritis. An open study of 46 patients. Review of the literature]. 290 46

Leucopenia is one of the most worrying of the many toxic effects of second-line drug therapy for rheumatoid arthritis, and much time and energy is expended in screening for it. Sulphasalazine (SASP) is generally claimed to be safer than some alternative second-line drugs but the reported incidence of leucopenia has varied widely. We have examined, retrospectively, all records of blood counts before, during and after treatment in 326 SASP treated patients and in 213 on gold. Leucopenia on at least one occasion occurred in up to 10% of patients on both drugs but usually recovered spontaneously in spite of continued therapy. 'Serious' leucopenia leading directly to drug withdrawal was a rare event occurring in only one SASP patient and in two patients receiving gold treatment. Most episodes of leucopenia do not require drug withdrawal and may not be drug related.
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PMID:Leucopenia in rheumatoid arthritis: relationship to gold or sulphasalazine therapy. 256 49

Sulphasalazine (SASP) has recently become established as an effective treatment for active rheumatoid arthritis (RA), but has not previously been used in psoriatic arthritis in which remission-inducing drugs have proved disappointing. In this one year open study, 34 patients with active psoriatic arthritis were treated with sulphasalazine. An overall favourable clinical response was observed in 23 patients (67%). Nine patients (26%) achieved a very good therapeutic response and these either had arthritis associated with spondylitis or the symmetrical type of joint disease. Evaluation at 3, 6 and 12 months showed a significant improvement in inflammatory indices including a reduction in the C-reactive protein level and ESR. The drug was well-tolerated and side-effects were mild. Eight patients (23.5%) stopped the drug because of reactions and one patient with a rash was successfully desensitised. Fifty-three percent continued the drug into the second year. No apparent exacerbation of the psoriasis was observed. These results suggest that sulphasalazine is a safe and potentially effective drug in the treatment of psoriatic arthritis. A double-blind placebo-controlled trial has been set up to determine its true efficacy.
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PMID:Treatment of psoriatic arthritis with sulphasalazine: a one year open study. 290 79

Sulfasalazine (SASP) has been used for many years as a disease-modifying agent in inflammatory bowel disease and in rheumatoid arthritis. However, its mode of action is not entirely clear. Evidence has been accumulated which indicates that its efficacy is due to an immunomodulatory effect. In the present communication, we report that SASP has an immunomodulatory capacity in an experimental rat cardiac allograft model. A combination of 100 mg/kg per day of SASP given orally until rejection and 10 mg/kg per day of cyclosporine A (CyA) given orally for 10 days resulted in a significantly increased graft survival time as compared to that in animals given CyA alone.
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PMID:The enhancing effect of cyclosporine A and sulfasalazine on the prevention of rejection in rat cardiac allografts. 290 20

The long term efficacy and tolerability of sulphasalazine (SASP) in the treatment of 21 patients with active classical or definite rheumatoid arthritis (RA) were examined and compared with the effects of penicillamine in a similarly active group of RA patients. Nineteen of the 21 patients treated with SASP improved during the first 6 months as shown by significant changes in the clinical and laboratory variables. Clinical improvement was maintained for the remainder of the year. Improvement in laboratory variables was maintained at 9 months but showed some deterioration at 1 year. Six patients went into remission by the ARA criteria, and 16 were able to continue the drug at the end of 1 year. In addition SASP had a steroid-sparing effect in 4 of the patients on systemic steroids. No potentially dangerous side effects were encountered by the end of the first year, although 5 patients were withdrawn. Dyspepsia, nausea and abdominal discomfort were the most common side-effects, although rashes (3) and macrocytosis (2) also occurred. Eighteen of the 21 patients treated with penicillamine improved during 9 months, although there was some deterioration at 1 year. Eight patients were withdrawn because of side-effects - thrombocytopenia (5), nephrotic syndrome (1) and proteinuria (2). This study suggests that SASP has a disease modifying action maintained over a year and associated with low toxicity. It is a useful addition to the small number of second-line drugs with a possibly different mode of action.
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PMID:The long term effects of sulphasalazine in the treatment of rheumatoid arthritis and a comparative study with penicillamine. 615 82

Long term treatment of 190 cases of rheumatoid arthritis with either methotrexate or salazosulfapyridine was analyzed for their efficacy and adverse effects. Both treatment groups showed improvement of clinical symptoms, erythrocyte sedimentation rate, and CRP after 1 month of treatment, while RAHA titers decreased significantly after several months. Erythrocyte sedimentation rate and CRP of salazo-sulfapyridine group, once improved, deteriorated again after 12 months of treatment, while methotrexate group showed sustained improvement for 48 months. Radiologic progression estimated according to JF Fries was significantly less in MTX group than in SASP group. Life table analysis showed that the overall probability of continuing methotrexate or salazosulfapyridine at 4 years was 63% and 55%, respectively. The main reason of treatment termination in methotrexate group was adverse effects, while that in salazo-sulfapyridine group was inefficacy.
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PMID:[Methotrexate and salazosulfapyridine in the long-term treatment of rheumatoid arthritis]. 748 63


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