Sulfasalazine Etanercept

Systemic therapies are seldom used for mild to moderate psoriasis, and are generally reserved for patients with moderate to severe psoriasis.17 29 Oral agents include sulfasalazine, acitretin, methotrexate, cyclosporine, mycophenolate mofetil, azathioprine, tacrolimus, and hydroxyurea. Parenteral agents include the biologic response modifiers alefacept, efalizumab, etanercept, infliximab, and many others, currently at various stages of research or approval for psoriasis. 

When added to methotrexate background therapy, cyclosporine, chloroquine, hydroxychloroquine, leflunomide, infliximab, adalimumab, rituximab, and etanercept have all shown improved efficacy. In contrast, azathioprine, auranofin, or sulfasalazine plus methotrexate results in no additional therapeutic benefit. Other combinations have occasionally been used, including the combination of intramuscular gold with hydroxychloroquine. 

Drugs are common causes of vasculitis, often occurring in the skin, but other organ involvement can occur. The pathogenesis of inflammation of small and medium-sized blood vessel walls caused by drugs is poorly understood. Even drugs used to treat inflammatory and immune-mediated disease, such as NSAIDs, sulfasalazine, and etanercept, can cause vasculitis. 

D. Pharmacokinetics and Clinical Use Sulfasalazine, hydroxychloroquine, methotrexate, cyclosporine, penicillamine and leflunomide are given orally. Infliximab and etanercept are given by injection. Gold compounds are available for parenteral use (gold sodium thiomalate and au-rothioglucose) and for oral administration (auranofin). 

Slow-acting antirheumatic drugs Methotrexate Hydroxychloroquine, sulfasalazine Infliximab, etanercept, leflunomide, penicillamine, gold... 

A study in patients taking sulfasalazine found that when etanercept was also given, patients had a decrease in neutrophil counts, when compared to other groups of patients receiving either drug alone. The clinical significance is not known. ... 

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