Sulfasalazine-Related Hypersensitivity Reactions in Patients With Rheumatic Diseases

• Published in: Journal of clinical rheumatology Vol. 23; no. 2; pp. 77 - 79
• Main Authors: Cildag, Songul, Senturk, Taskin
• Format: Journal Article
• Language: English
• Published: United States Copyright Wolters Kluwer Health, Inc. All rights reserved 01-03-2017
• Subjects: Adult; Aged; Antirheumatic Agents - administration & dosage; Antirheumatic Agents - adverse effects; Arthritis, Rheumatoid - diagnosis; Arthritis, Rheumatoid - drug therapy; Dose-Response Relationship, Drug; Drug Hypersensitivity - diagnosis; Drug Hypersensitivity - etiology; Drug Hypersensitivity - physiopathology; Drug Hypersensitivity - therapy; Drug Monitoring - methods; Female; Follow-Up Studies; Glucocorticoids - administration & dosage; Histamine Antagonists - administration & dosage; Humans; Male; Middle Aged; Outcome and Process Assessment (Health Care); Patient Acuity; Spondylitis, Ankylosing - diagnosis; Spondylitis, Ankylosing - drug therapy; Sulfasalazine - administration & dosage; Sulfasalazine - adverse effects; Turkey; Withholding Treatment
• ISSN: 1076-1608; 1536-7355
• DOI: 10.1097/RHU.0000000000000490

BACKGROUNDSulfasalazine (SSZ), which has an arylamine sulfonamide structure, is an anti-inflammatory drug used in the treatment of many rheumatic diseases. Various adverse effects have been reported related to SSZ. In the present study, we aimed to define the frequency of SSZ-related hypersensitivity reaction in patients with rheumatoid arthritis and ankylosing spondylitis.
METHODSA total of 136 patients were included in this study. During follow-ups, reaction type, reaction duration, and drug doses were recorded in patients who developed hypersensitivity reactions. Drugs were discontinued in patients who developed reactions, and they were treated with antihistaminics and/or corticosteroids, according to requirements. Drug provocation tests with the drugs and aminosalicylic acid were performed in patients with negative skin prick test individually.
RESULTSA total of 136 patients, with ages ranging from 19 to 71 years (mean, 41.97 [SD, 12.04] years), were included in the study. Hypersensitivity reactions according to the drug provocation test were found against SSZ in 12 patients (8.8%). The SSZ-related hypersensitivity reaction types were urticaria in 7 patients, urticaria and angioedema in 4 patients, and pruritus in 1 patient.
CONCLUSIONSSulfasalazine is widely used by rheumatologists in the treatment of rheumatic diseases. Whereas the frequency of sulfonamide-related hypersensitivity reactions was reported as 3.0% in the population, we detected hypersensitivity reactions to be 8.8% with SSZ usage in rheumatic diseases.