Sulfasalazine Improves Psoriasis: A Double-blind Analysis
Abstract
• In an 8-week double-blind trial of sulfasalazine for the treatment of moderate-to-severe psoriasis, 23 and 27 patients received the active and placebo tablets, respectively. At the end of the double-blind phase, there were 17 assessable patients receiving sulfasalazine; 7 (41%) had marked improvement, 7 (41%) had moderate improvement, and 3 (18%) demonstrated minimal change. Only 1 patient receiving placebo demonstrated moderate improvement, whereas the rest had minimal improvement or worsening of psoriasis. When the randomization code was broken, patients receiving sulfasalazine were allowed to continue therapy for an additional 4 weeks in an open manner, while those using placebo left the study. Six of 23 patients discontinued sulfasalazine therapy during the double-blind phase because of side effects, 4 due to the development of a cutaneous eruption and 2 due to nausea. Fourteen of 17 patients, who were assessable at the end of the 8-week double-blind phase, completed the additional 4 weeks of sulfasalazine therapy. Of these 14 patients, marked improvement occurred in 8 (57%), moderate improvement in 2 (14%), and minimal improvement in 4 (29%), compared with pretherapy. The low incidence of severe side effects makes sulfasalazine a consideration for oral therapy in patients whose disease severity does not justify use of methotrexate, etretinate, or psoralen plus UV-A, but whose disease severity is too widespread for safe and practical use of topical corticosteroids. (Arch Dermatol. 1990;126:487-493)
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Sulfasalazine has been used for decades to treat autoimmune inflammatory bowel disease and psoriatic arthritis.
“Intriguingly, sulfasalazine, a drug used for decades to treat autoimmune inflammatory bowel disease (IBD) and psoriatic arthritis (Gupta et al., 1990), is now recognized as targeting the BH4 pathway by inhibiting SPR (Haruki et al., 2013), in addition to other targets, such as NFκB (Wahl et al., 1998).”
From The Role of Iron Regulation in Immunometabolism and Immune-Related Disease (2019) · cites this paper as Gupta et al., 1990
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Guidelines of care for the management of psoriasis and psoriatic arthritis
Menter, A., Korman, N. J., Elmets, C. A., Feldman, S. R., Gelfand, J. M., Gordon, K. B., Gottlieb, A. B., Koo, J. Y. M., Lebwohl, M., Lim, H. W., et al. (2009) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2009.03.027 · Cited by 555 · see citing works
Tsoi, L. C., Stuart, P. E., Tian, C., Gudjonsson, J. E., Das, S., Zawistowski, M., Ellinghaus, E., Barker, J. N., Chandran, V., Dand, N., et al. (2017) · Nature Communications · doi:10.1038/ncomms15382 · Cited by 384 · see citing works
The Role of Iron Regulation in Immunometabolism and Immune-Related Disease
Cronin, S. J. F., Woolf, C. J., Weiss, G., & Penninger, J. M. (2019) · Frontiers in Molecular Biosciences · doi:10.3389/fmolb.2019.00116 · Cited by 299 · see citing works
Mease, P. J., & Armstrong, A. W. (2014) · Drugs · doi:10.1007/s40265-014-0191-y · Cited by 272 · see citing works
An approach to the treatment of moderate to severe psoriasis with rotational therapy
Weinstein, G. D., & White, G. M. (1993) · Journal of the American Academy of Dermatology · doi:10.1016/0190-9622(93)70067-4 · Cited by 143 · see citing works
Whitlock, S. M., Enos, C., Armstrong, A. W., Gottlieb, A. B., Langley, R. G. B., Lebwohl, M., Merola, J. F., Ryan, C., Siegel, M. P., Weinberg, J. M., et al. (2018) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2017.06.043 · Cited by 83 · see citing works
MANAGEMENT OF REFRACTORY ANKYLOSING SPONDYLITIS AND RELATED SPONDYLOARTHROPATHIES
Amor, B., Dougados, M., & Khan, M. A. (1995) · Rheumatic Disease Clinics of North America · doi:10.1016/s0889-857x(21)00374-4 · Cited by 81 · see citing works
Proceedings of the Psoriasis Combination and Rotation Therapy Conference
Menter, M. A., See, J., AMEND, W. J. C., Ellis, C. N., Krueger, G. G., Lebwohl, M. G., Morison, W. L., & Prystowsky, J. H. (1996) · Journal of the American Academy of Dermatology · doi:10.1016/s0190-9622(96)80148-4 · Cited by 76 · see citing works
Sulfasalazine for alopecia areata
Ellis, C. N., Brown, M. F., & Voorhees, J. J. (2002) · Journal of the American Academy of Dermatology · doi:10.1067/mjd.2002.119671 · Cited by 65 · see citing works
Mechanism of action of 5‐arninosalicylic acid
Punchard, N. A., Greenfield, S. M., & Thompson, R. P. H. (1992) · Mediators of Inflammation · doi:10.1155/s0962935192000243 · Cited by 64 · see citing works
Kiwalkar, S., Rosenbaum, J. T., Schwartzman, S., Dutz, J. P., & den Bosch, F. V. (2019) · Elsevier eBooks · doi:10.1016/b978-0-323-56800-5.00011-4 · Cited by 52 · see citing works
Lack of Association Between NOD2 3020InsC Frameshift Mutation and Psoriasis
Nair, R. P., Stuart, P. E., Ogura, Y., Inohara, N., Chia, N. V. C., Young, L., Henseler, T., Jenisch, S., Christophers, E., Voorhees, J. J., et al. (2001) · Journal of Investigative Dermatology · doi:10.1046/j.0022-202x.2001.01620.x · Cited by 51 · see citing works
Sulfasalazine in dermatology: A lesser explored drug with broad therapeutic potential
Mushtaq, S., & Sarkar, R. (2020) · International Journal of Women’s Dermatology · doi:10.1016/j.ijwd.2020.01.009 · Cited by 48 · see citing works
Safety concerns with current treatments for psoriasis in the elderly
Caprio, R. D., Caiazzo, G., Cacciapuoti, S., Fabbrocini, G., Scala, E., & Balato, A. (2020) · Expert Opinion on Drug Safety · doi:10.1080/14740338.2020.1728253 · Cited by 38 · see citing works
Current and Future Oral Systemic Therapies for Psoriasis
Kelly, J. B., Foley, P. A., & Strober, B. E. (2014) · Dermatologic Clinics · doi:10.1016/j.det.2014.09.008 · Cited by 37 · see citing works
Open Trial of Leflunomide for Refractory Psoriasis and Psoriatic Arthritis
Liang, G. C., & Barr, W. G. (2001) · JCR Journal of Clinical Rheumatology · doi:10.1097/00124743-200112000-00003 · Cited by 36 · see citing works
Strober, B. E., Berger, E., Cather, J. C., Cohen, D., Crowley, J., Gordon, K. B., Gottlieb, A. B., Horn, E. J., Kavanaugh, A. F., Korman, N. J., et al. (2009) · Journal of the American Academy of Dermatology · doi:10.1016/j.jaad.2009.03.017 · Cited by 35 · see citing works
Chien, A. L.-L., Elder, J. T., & Ellis, C. N. (2009) · Drugs · doi:10.2165/00003495-200969090-00001 · Cited by 34 · see citing works
Is psoriasis a bowel disease? Successful treatment with bile acids and bioflavonoids suggests it is
Ely, P. H. (2018) · Clinics in Dermatology · doi:10.1016/j.clindermatol.2018.03.011 · Cited by 31 · see citing works
Griffiths, C. E. M., & Barker, J. N. (2010) · doi:10.1002/9781444317633.ch20 · Cited by 29 · see citing works
Równicka-Zubik, J., Sułkowska, A., Pożycka, J., Gaździcka, K., Bojko, B., Maciążek-Jurczyk, M., & Sułkowski, W. W. (2008) · Journal of Molecular Structure · doi:10.1016/j.molstruc.2008.12.053 · Cited by 26 · see citing works
Sulfasalazine and pentoxifylline in psoriasis: A possible safe alternative
El-Mofty, M. A., El‐Darouti, M., Rasheed, H. M., Bassiouny, D. A., Abdel‐Halim, M. R. E., Zaki, N. S., El‐Hanafy, G. M., Hadidi, H. H. E., Azzam, O. A., El-Ramly, A. Z., et al. (2010) · Journal of Dermatological Treatment · doi:10.3109/09546630903460260 · Cited by 26 · see citing works
Optimal Management of Severe Plaque Form of Psoriasis
Fairhurst, D. A., Ashcroft, D. M., & Griffiths, C. E. M. (2005) · American Journal of Clinical Dermatology · doi:10.2165/00128071-200506050-00002 · Cited by 25 · see citing works
Hachem, K., Opulencia, M. J. C., Abdelbasset, W. K., Севбитов, А. В., Kuzichkin, O. R., Mohamed, A., Rad, S. M., Salehi, A., Kaur, J., Kumar, R., et al. (2022) · Journal of Molecular Liquids · doi:10.1016/j.molliq.2022.119030 · Cited by 22 · see citing works
RetractedSevere megaloblastic anemia in a patient receiving low-dose methotrexate for psoriasis
Casserly, C. M., Stange, K. C., & Chren, M. (1993) · Journal of the American Academy of Dermatology · doi:10.1016/0190-9622(93)70215-f · Cited by 22 · see citing works
Evaluation of sulphasalazine in the treatment of spondyloarthropathies.
Dougados, M., Maetzel, A., Mijiyawa, M., & Amor, B. (1992) · Annals of the Rheumatic Diseases · doi:10.1136/ard.51.8.955 · Cited by 22 · see citing works
Carlin, G., Djursäter, R., & SMEDEGÅRD, G. (1992) · Annals of the Rheumatic Diseases · doi:10.1136/ard.51.11.1230 · Cited by 21 · see citing works
EFFICACY OF SULFASALAZINE IN DISCOID LUPUS ERYTHEMATOSUS
Artüz, F., Lenk, N., Deniz, N., & Allı, N. (1996) · International Journal of Dermatology · doi:10.1111/j.1365-4362.1996.tb00657.x · Cited by 19 · see citing works
Treatment of psoriatic arthritis
Cuellar, M. L., Citera, G., & Espinoza, L. R. (1994) · Baillière s Clinical Rheumatology · doi:10.1016/s0950-3579(94)80030-8 · Cited by 18 · see citing works
Mate, C. J., Mishra, S. K., & Srivastava, P. K. (2020) · International Journal of Biological Macromolecules · doi:10.1016/j.ijbiomac.2020.02.009 · Cited by 17 · see citing works
Correale, J. D., Olsson, T. P., Björk, J., SMEDEGÅRD, G., Höjeberg, B., & Link, H. (1991) · Journal of Neuroimmunology · doi:10.1016/0165-5728(91)90120-v · Cited by 16 · see citing works
Antimicrobial Treatment of Psoriasis
Skinner, R. B., Rosenberg, E. W., & Noah, P. W. (1995) · Dermatologic Clinics · doi:10.1016/s0733-8635(18)30053-6 · Cited by 15 · see citing works
Unconventional treatment options in psoriasis: A review
Neema, S., Sandhu, S., Gupta, A., Jagadeesan, S., & Vasudevan, B. (2021) · Indian Journal of Dermatology Venereology and Leprology · doi:10.25259/ijdvl_22_2021 · Cited by 15 · see citing works
Self-citationGriffiths, C. E. M., Camp, R. D. R., & Barker, J. N. (2004) · doi:10.1002/9780470750520.ch35 · Cited by 12 · see citing works
Candidate drug replacements for quinacrine in cutaneous lupus erythematosus
Yan, D. D., Borucki, R., Sontheimer, R. D., & Werth, V. P. (2020) · Lupus Science & Medicine · doi:10.1136/lupus-2020-000430 · Cited by 11 · see citing works
Carron, P., Praet, L. V., Jacques, P., Elewaut, D. S., & den Bosch, F. E. V. (2012) · Rheumatic Disease Clinics of North America · doi:10.1016/j.rdc.2012.08.017 · Cited by 10 · see citing works
Feldman, S. R. (1998) · Current Problems in Dermatology · doi:10.1016/s1040-0486(98)90003-5 · Cited by 10 · see citing works
Maharaj, A. B., & Chandran, V. (2016) · Expert Review of Clinical Immunology · doi:10.1080/1744666x.2017.1257939 · Cited by 8 · see citing works
Jullien, D., Wolkenstein, P., Roupie, É., Roujeau, J., & Revuz, J. E. (1995) · Arthritis & Rheumatism · doi:10.1002/art.1780380420 · Cited by 8 · see citing works
Mangold, A. R., & Pittelkow, M. R. (2017) · Springer eBooks · doi:10.1007/978-3-319-29785-9_31 · Cited by 5 · see citing works
Induction of glioblastoma invasion triggered by system Xc−-mediated glutamate release
Baik, J., Lee, M.-H., Yoo, J. H., Jo, A., & Han, K. (2024) · Molecular & Cellular Toxicology · doi:10.1007/s13273-024-00433-x · Cited by 4 · see citing works
Pittelkow, M. R., & Genebriera, J. (2009) · Elsevier eBooks · doi:10.1016/b978-1-4160-3291-5.50075-5 · Cited by 3 · see citing works
Oral treatment options for AS and PsA: DMARDs and small-molecule inhibitors
Chan, J. J., & Gladman, D. D. (2018) · Best Practice & Research Clinical Rheumatology · doi:10.1016/j.berh.2018.08.003 · Cited by 3 · see citing works
PSORIASIS TREATMENT WITH 5‐AMINOSALICYLIC ACID
Cortés‐Franco, R., Fernández, L. M. P., & Domínguez‐Soto, L. (1994) · International Journal of Dermatology · doi:10.1111/j.1365-4362.1994.tb02900.x · Cited by 2 · see citing works
Evaluation of the role of sulphasalazine in the treatment of moderate to severe psoriasis
Boyd, J., Eedy, D. J., Bingham, E., & Burrows, D. (1991) · Journal of Dermatological Treatment · doi:10.3109/09546639109089044 · Cited by 2 · see citing works
Pattern of drug use in the management of psoriasis in a tertiary care hospital: a prospective study
Raghunandan, R., Pundarikaksha, H. P., & Gopal, M. G. (2014) · International Journal of Basic & Clinical Pharmacology · doi:10.5455/2319-2003.ijbcp20140808 · Cited by 2 · see citing works
BREATHNACH, S. M., Griffiths, C. E. M., Chalmers, R. J. G., & Hay, R. J. (2004) · doi:10.1002/9780470750520.ch72 · Cited by 2 · see citing works
Systemic Therapies in Psoriasis
Peterson, G. M., Silfvast‐Kaiser, A., & Menter, A. (2017) · Springer eBooks · doi:10.1007/978-3-319-66884-0_16 · Cited by 1 · see citing works
Antimetabolites and Sulfasalazine
Camisa, C. (2004) · doi:10.1002/9780470750704.ch19
Gawkrodger, D. J. (1991) · The Lancet · doi:10.1016/0140-6736(91)91350-4
Coskey, R. J. (1991) · Journal of the American Academy of Dermatology · doi:10.1016/0190-9622(91)70195-8
Narang, T. K., & Handa, S. (2014) · Journal of Postgraduate Medicine Education and Research · doi:10.5005/jp-journals-10028-1095
Guilhou, J. (2006) · EMC - Dermatologie · doi:10.1016/s0246-0319(06)73786-4
Masche, U., & Weißenbach, T. (2001) · pharma-kritik · doi:10.37667/pk.2001.266
- Authors
- Gupta, A. K.
- Corresponding author
- Gupta, Aditya K.
- ORCID
- Gupta, Aditya K.
- Venue
- Archives of Dermatology
- Publisher
- American Medical Association (AMA)
- Published
- 1990-04-01
- Volume
- 126
- Issue
- 4
- Pages
- 487
- ISSN
- 0003-987X (ISSN-L)
- OpenAlex
- W4328006832
- Cited by
- 54
- References
- 0
- Citations by year
- 2024: 1 · 2022: 1 · 2021: 1 · 2020: 4 · 2019: 2 · 2018: 3 · 2017: 3 · 2016: 1 · 2014: 4 · 2012: 1
- FWCI
- 1.50
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Archives of Dermatology (publishedVersion)
- Topics
- Life Sciences › Immunology and Microbiology › Immunology › Psoriasis: Treatment and Pathogenesis
- Health Sciences › Medicine › Dermatology › Dermatology and Skin Diseases
- Health Sciences › Medicine › Rheumatology › Spondyloarthritis Studies and Treatments
- Keywords
- sulfasalazine, psoriasis, oral therapy, drug efficacy, adverse effects, rash, moderate-to-severe psoriasis
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