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Sulfasalazine is used in the treatment of inflammatory bowel disease, including ulcerative colitis and Crohn's disease. It is also indicated for use in rheumatoid arthritis and used in other types of inflammatory arthritis (e.g. psoriatic arthritis and reactive arthritis). [11] [3] [2] It is usually not given to children under two years of age ...
Once remission is induced, maintenance levels can be used: sulfasalazine 2 g/day, mesalamine 1.2-2.4 g/day, or olsalazine 1 g/day. Patients on high dose sulfasalazine require folic supplementation (1 mg/day) because it inhibits folate absorption. If oral Mesalazine is still not working, prednisone is often given, starting at 40–60 mg/day.
5-ASA compounds, such as mesalazine and sulfasalazine, have shown to be of very little efficacy in the treatment of Crohn's disease, either for induction or for maintenance of remission. [2] Current guidelines do not advise the use of 5-ASA compounds in Crohn's disease.
Mesalazine is the active moiety of sulfasalazine, which is metabolized to sulfapyridine and mesalazine. [20] It is also the active component of the prodrug balsalazide along with the inert carrier molecule 4-aminobenzoyl-beta-alanine. [21] It is in the category of disease-modifying antirheumatic drugs (DMARDs) family of medications. [22]
Mirikizumab, a drug currently approved by the Food and Drug Administration (FDA) for the treatment of ulcerative colitis, also sends Crohn's disease into clinical remission, new findings suggest.
For ulcerative colitis, sulfasalazine has been demonstrated to be beneficial in treating flare-ups as well as the underlying condition; [29] however, the picture for Crohn's disease is less clear. Sulfasalazine has been demonstrated to be beneficial in certain trials for Crohn's disease, [30] but not in others. [31]
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