Salsalate: its role in the management of rheumatic disease

Our present array of nonsteroidal anti-inflammatory drugs (NSAIDs) provides many more avenues for the long-term management of rheumatic disease. Their clinical efficacy notwithstanding, these drugs possess significant iatrogenic potential. These risks are typified by aspirin side effects, basically gastrointestinal, hematologic, and thrombopathic. Most of the NSAIDs share these liabilities. However, there is now wider appreciation of recent findings that nonacetylated salicylates, particularly salsalate, provide the benefits of aspirin and other NSAIDs but not their dangers. Salsalate is a prototypic drug of this class; it is reviewed in detail with appropriate comment concerning its present and potential clinical contributions to antirheumatic therapy.