Leucopenia during sulphasalazine treatment for rheumatoid arthritis

Article Abstract:

Rheumatoid arthritis (RA), an inflammatory joint disease, is characterized by swelling, stiffness, hypertrophy or enlargement of the cartilage, and pain. One of the drugs used to treat RA, sulfasalazine, has been shown to cause leukopenia, an abnormal decrease in the number of white blood cells. The outcome and prevalence of sulfasalazine-induced leukopenia is not clearly known. The incidence, severity and outcome of sulfasalazine-related leukopenia was evaluated in patients with RA over a period of five years. Factors that may predict the outcome of this blood disease were also examined. Leukopenia was detected in 20 patients, resulting in an overall incidence of 5.6 percent, and treatment with sulfasalazine was discontinued for these patients. Fourteen patients developed leukopenia early in treatment or within 24 weeks of starting sulfasalazine therapy. Since leukopenia may also develop later in treatment, continual monitoring of blood is required. No predictive factors for leukopenia could be determined. Patients recovered completely from sulfasalazine-related leukopenia after adjustment of dose or withdrawal of the drug. (Consumer Summary produced by Reliance Medical Information, Inc.)

Causes of, Leukocytes, White blood cells, Leucopenia, Leukopenia

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Second line (disease modifying) treatment in rheumatoid arthritis: which drug for which patient?

Article Abstract:

Gold, penicillamine or sulphasalazine may be an effective treatment for patients with active rheumatoid arthritis (RA). RA is an inflammatory disease that affects the joints. Among 1,140 patients with RA who were followed during the first year of treatment, 500 were treated with intramuscular gold, 158 with penicillamine, 352 with sulfasalazine and 130 with auranofin. Approximately 60% of the patients in the gold, penicillamine or sulphasalazine groups were still being treated at one year, compared with 52% of the patients in the auranofin group. More patients in the auranofin group discontinued treatment because of lack or loss of effect. Treatment response was similar for patients in the gold, penicillamine and sulphasalzine groups. Patients with RA of longer duration were more likely to discontinue treatment than other patients.

Health aspects, Gold, Penicillamine

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Low dose desensitisation does not reduce the toxicity of sulphasalazine in rheumatoid arthritis

Article Abstract:

Pretreatment with progressively higher strength sulphasalazine does not seem to change the adverse effects of full strength sulphasalazine given later to patients with rheumatoid arthritis (RA). Researchers compared the adverse effects in 422 patients with RA given either a 3-week pretreatment with progressively higher strength sulphasalazine or pretreatment with placebo before beginning full strength sulphasalazine treatment. There was a similar percentage of reported adverse effects in those receiving sulphasalazine (65.8%) as in the control group (61.1%). Improvements in laboratory test results including C reactive protein levels and erythrocyte sedimentation rates and in disease symptoms including morning stiffness and pain were similar for both groups at three and six months following treatment.

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