Sulphasalazine in rheumatoid arthritis: haematological problems and changes in haematological indices associated with therapy.
This prospective study documents the haematological responses in 300 rheumatoid patients (RA) treated with sulphasalazine (SASP) for between 1 and 9 years. It also examines the effect of SASP on the total white cell and platelet counts over 2 years in relation to disease activity in 80 RA patients. Neutropenia occurred in six (2%) (three severe--neutrophil count less than 0.8 X 10(9)/l) after 3 and 12 weeks. The drug was withdrawn in six immediately and in one patient after 21 months when the neutrophil count fell to 0.7 X 10(9)/l. An additional 11 (3.7%) developed mild or transient leucopenia between 2 weeks and 24 months, and eight continued therapy. Thrombocytopenia occurred in one patient at 18 weeks associated with other reactions. Four with Felty's syndrome developed a further fall in the total WBC associated with thrombocytopenia in two. A rise in mean cell volume was common (72%), and macrocytosis (MCV greater than 98 fl) occurred in 27 (9%). Macrocytic anaemia was rare (less than 1%). All haematological problems were reversible. In 80 patients treated with SASP for 2 years there was a significant fall in the median white cell and platelet counts at 3 months associated with improvement in disease activity.
Farr
M
M
Department of Rheumatology, University of Birmingham, Medical School, UK.
Tunn
E J
EJ
Symmons
D P
DP
Scott
D G
DG
Bacon
P A
PA
D000293:Adolescent; D000328:Adult; D000368:Aged; D001172:Arthritis, Rheumatoid / Q000097:blood / Q000188:drug therapy*; D005258:Felty Syndrome / Q000139:chemically induced; D005260:Female; D006402:Hematologic Diseases / Q000139:chemically induced*; D006801:Humans; D007958:Leukocyte Count / Q000187:drug effects; D008297:Male; D008875:Middle Aged; D009503:Neutropenia / Q000139:chemically induced; D010976:Platelet Count / Q000187:drug effects; D012460:Sulfasalazine / Q000009:adverse effects / Q000627:therapeutic use*
D012460:Sulfasalazine