Sulfasalazine and Psoriatic Arthritis

Sulfasalazine's Role in Psoriatic Arthritis Treatment

Sulfasalazine isn't really "first line" or "gold standard" therapy for psoriatic arthritis, largely due to the fact that other medications have more evidence (larger, longer, or better-designed studies) to support its use for this condition.
A somewhat similar medication, methotrexate, is more commonly used and has more evidence to support its use. However, some people do not respond adequately to methotrexate or cannot take the drug due to dangerous or intolerable side effects. In such situations, sulfasalazine may be a good alternative.
It is not fully understood exactly how sulfasalazine works for psoriatic arthritis. However, it is thought that the medication likely works by decreasing inflammation and affecting the immune system.

What Are the Risks?

While sulfasalazine can be a good option for some individuals, it is not without risk. Some of the more important and serious risks of taking sulfasalazine (for any use) include the following:
  • Sulfasalazine is a sulfonamide drug (a "sulfa" drug) and cannot be used by people allergic to sulfa medications.
  • This medication can decrease sperm production in men. This is usually temporary and corrects itself once sulfasalazine is stopped. However, this can be quite troublesome for couples who are trying to conceive.
  • The medication may not be safe to use in people with severe asthma or allergies, kidney disease, liver disease, or anemia (or any other low blood counts). Be sure to tell your healthcare provider if you have any of these conditions before taking sulfasalazine.

Is Sulfasalazine Right for My Psoriatic Arthritis?

Sulfasalazine is a medication occasionally used in psoriatic arthritis treatment. While it doesn't have as much evidence to support its use as some of the other medications more commonly used, it certainly is an option, especially for people who do not tolerate the other medications well.
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