Adverse Reactions to Sulphasalazine

Sulphasalazine is a drug which is the therapeutic mainly in the prevention of recurrence of ulcerative colitis and is also used in the treatment of active disease. It c?nsists of a sulphonamide (sulphapyridine) and a salicylate (5-amino salicylic acid) component with the 'atter being the active moiety in colitis. However it was 0riginally developed as a treatment for rheumatoid arthritis (1) and in the past 3 years there has been a renaissance both locally and nationally in its use by rheumatologists as a second line agent in the treatment ?f rheumatoid arthritis (2,3) and to a lesser extent in ar>kylosing spondylitis. It is regarded as a safe drug when c?rnpared with the severe side effects reported with the other commonly used disease-modifying agents in rheumatoid arthritis such as gold and penicillamine. We would like to add a note of caution to this view of SlJlphasalazine by reporting three cases of severe neutr?Penia in patients which occurred over a four month Period between 1983 and 1984 in the Bristol Royal Infirmary in association with this drug.