title: Relationship between the acetylator phenotype, plasma sulfapyridine levels and adverse effects during treatment with salicylazosulfapyridine in patients with chronic bowel diseases.
abstract: We examined 122 patients with inflammatory bowel disease treated with salicylazosulfapyridine. Forty-two (34.5%) had adverse effects that led to discontinuation of therapy in 14 (11.5%). In 33 patients the effects appeared to be dose dependent. The plasma sulfapyridine levels in patients exhibiting gastrointestinal side effects were significantly higher than in patients with no adverse effects (41.0 +/- 20.3 and 23.8 +/- 14.8 micrograms/ml respectively, P less than 0.001). Plasma sulfapyridine levels were significantly higher in slow than in fast acetylators (31.5 +/- 17.1 vs. 22.2 +/- 17.1 micrograms/ml). Slow acetylators had three times as many side effects as fast acetylators; however this difference was not statistically significant.
authors.affiliation: Department of Medicine, Hadassah University Hospital, Mt. Scopus, Israel.
authors.forename: G
authors.initials: G
authors.lastname: Rahav
authors.forename: E
authors.initials: E
authors.lastname: Zylber-Katz
authors.forename: D
authors.initials: D
authors.lastname: Rachmilewitz
authors.forename: M
authors.initials: M
authors.lastname: Levy
mesh_terms: D000107:Acetylation; D000293:Adolescent; D000328:Adult; D000368:Aged; D002908:Chronic Disease; D004305:Dose-Response Relationship, Drug; D005260:Female; D006801:Humans; D015212:Inflammatory Bowel Diseases / Q000188:drug therapy* / Q000235:genetics / Q000378:metabolism; D008297:Male; D008875:Middle Aged; D009325:Nausea / Q000139:chemically induced; D010641:Phenotype; D012189:Retrospective Studies; D013424:Sulfanilamides / Q000097:blood*; D013427:Sulfapyridine / Q000097:blood* / Q000378:metabolism; D012460:Sulfasalazine / Q000008:administration & dosage / Q000009:adverse effects* / Q000378:metabolism; D013997:Time Factors
chemical_list: D013424:Sulfanilamides; D012460:Sulfasalazine; D013427:Sulfapyridine