The use of sulphasalazine as a disease modifying antirheumatic drug

SASP is a useful DMARD in RA and is probably useful in early ankylosing spondylitis, psoriatic arthropathy and reactive arthritis. It shares many of the characteristics of other DMARDs such as gold and penicillamine. It produces improvement in clinical and laboratory parameters of disease activity, with a slow onset of action--8-12 weeks elapse before beneficial effect is noted. SASP probably slows radiological progression of RA but definitive proof is difficult to obtain. Although side-effects are common, these are often managed by a reduction in dose, and serious adverse events requiring cessation of therapy are uncommon. Serious side-effects do occur however, and regular monitoring with full blood counts is recommended. The mechanism of action of SASP is unknown and this remains one of the principal areas of research interest.