Adverse effects of sulfasalazine: discussion of mechanism and role of sulfonamide structure

Thérapie
Rim AtheymenSerria Hammami

Abstract

Sulfasalazine is widely used in the treatment of chronic inflammatory bowel disease (IBD) and certain rheumatic diseases. However, its use is associated with a high rate of adverse effects (AEs) which can be cutaneous, hematological, renal, hepatic, gastrointestinal or neurological. The aim of our study was to collect all cases of AEs suspected to be associated with the use of sulfasalazine in patients hospitalized in the department of Gastroenterology from the Hospital Hedi Chaker of Sfax (Tunisia) for a period of 5 years and to search the incriminated fraction (sulfonamide or salicylate). Our study population included 69 patients who received sulfasalazine for the treatment of IBD. We collected, in 23 patients (33%), 25 AEs suspected to be related to sulfasalazine. Cutaneous and hematological reactions are the most common. The subsequent administration of mesalazine was performed in 15 patients. It was well tolerated in 14 patients. So we were suspecting probably the responsibility of sulfonamide fraction in these cases. The mechanism of sulfasalazine induced AEs may be toxic or immunoallergic with the possibility of a cross-reaction with the other antimicroacterial sulfonamides.

References

Mar 23, 2004·Pharmaceutical Research·Shunichi KumagaiKatsuhiko Okumura
Nov 13, 2004·Revista Española De Enfermedades Digestivas : Organo Oficial De La Sociedad Española De Patología Digestiva·A GarridoF J Guerrero
Apr 24, 2010·International Archives of Allergy and Immunology·Anna ZawodniakWerner J Pichler
Oct 12, 2010·Digestive Diseases·Omar S Khokhar, James H Lewis

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Citations

May 22, 2021·Pharmacological Reviews·Samantha Christine SernoskieJack Paul Uetrecht

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