5-Aminosalicylic acid or sulphapyridine. Which is the active moiety of sulphasalazine in rheumatoid arthritis?

Abstract

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

• Authors: A J Taggart, V C Neumann, J Hill, C Astbury, P Le Gallez, J S Dixon
• Journal: Drugs (Drugs) Vol. 32 Suppl 1 Pg. 27-34 ( 1986) ISSN: 0012-6667 [Print] New Zealand
• PMID: 2877851 (Publication Type: Comparative Study, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Aminosalicylic Acids
• Anti-Inflammatory Agents, Non-Steroidal
• Sulfanilamides
• Sulfasalazine
• Mesalamine
• Sulfapyridine

Topics

• Adult
• Aged
• Aminosalicylic Acids (therapeutic use)
• Anti-Inflammatory Agents, Non-Steroidal (therapeutic use)
• Arthritis, Rheumatoid (drug therapy)
• Female
• Humans
• Male
• Mesalamine
• Middle Aged
• Sulfanilamides (therapeutic use)
• Sulfapyridine (therapeutic use)
• Sulfasalazine (therapeutic use)