Sulphasalazine is a "disease modifying" drug that is now widely used in rheumatoid arthritis, having fewer and milder side effects than gold or penicillamine.' One potential side effect, which is easily missed and may become life threatening, is macrocytic anaemia. This occurs in 2-3% of prising and possibly to "reflect the brittle state of folate metabolism in rheumatoid arthritis." Since then...

The effects of sulphasalazine on the production of second messenger compounds in human granulocytes have been characterised by various stimuli. The increases in cytosolic calcium, inositol trisphosphate, diacylglycerol, and phosphatidic acid (all important mediators of intracellular signal transduction) triggered by stimulation were inhibited by sulphasalazine. The metabolites 5-amino-salicylic...

Sulphasalazine is a drug which is widely used in the treatment of ulcerative colitis. Although a high incidence of side effects has been reported, pulmonary complications of treatment have not been described previously. The clinical, haematological, and radiological abnormalities which occurred in one patient two months after sulphasalazine was started are described. Withdrawal of treatment was...

BACKGROUND The value of intensive combination therapy in early rheumatoid arthritis is unproven. In a multicentre, double-blind, randomised trial (COBRA), we compared the combination of sulphasalazine (2 g/day), methotrexate (7.5 mg/week), and prednisolone (initially 60 mg/day, tapered in 6 weekly steps to 7.5 mg/day) with sulphasalazine alone. METHODS 155 patients with early rheumatoid arthr...

The regression of small rheumatoid nodules was noted in four patients after starting sulphasalazine therapy. This coincided with an improvement in synovitis and also falls in erythrocyte sedimentation rate (ESR) and C reactive protein (CRP). The relation between the nodule regression and the sulphasalazine therapy is discussed.

An increased incidence of colonic cancer is associated with chronic inflammatory bowel disease. Sulphasalazine, metronidazole and more recently, modified forms of 5-aminosalicylic acid are used for maintenance therapy of inflammatory bowel disease. In a series of experiments, we used the 1,2-dimethylhydrazine animal model of colonic cancer in conjunction with these drugs, to study the effect on...

In a Danish multicentre trial we compared the relapse preventing effects of olsalazine and sulphasalazine in patients with ulcerative colitis over a 12 month treatment period. Two hundred and twenty seven patients (118 men) with at least two previous attacks of ulcerative colitis were randomly allocated according to a prearranged treatment schedule to olsalazine 500 mg bd or sulphasalazine 1 g ...

There is no doubt that the outlook for the patient with ulcerative colitis is better than it was 50 years ago when sulphasalazine was first introduced.' Much of the decreased mortality can be attributed to corticosteroids first shown to be effective in ulcerative colitis in 1952. The next milestone was widespread prescription of sulphasalazine, once it had been clearly established that it prolo...

A woman with ulcerative colitis was treated with sulphasalazine and prednisolone. After four months' treatment she began to get short of breath and she died a month later with severe subacute fibrosing alveolitis. It is believed that the lung disease was caused by sulphasalazine and that prednisolone was not able to prevent its development. A reversible form of lung disease has previously been ...