Psoriasis sulfasalazine

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. 

Sulfasalazine has variable efficacy and is of limited potency. However, its side-effect profile is better than other systemic therapies and it is sometimes tried as an initial systemic agent for moderate to severe psoriasis. Usual doses are 2 to 4 g/day in divided doses.10... 

Sulfasalazine (Azulfidine, Azulfidine EN) [Anti-inflammatory/ Antirheumatic (DMARD)/Sulfonamide] Uses Ulcerative colitis, RA, juvenile RA, active Crohn Dz, ankylosing spondylitis, psoriasis Action Sulfonamide actions unclear Dose Adults. Initial, 1 g PO tid-qid T to a max of 8 g/d in 3 -5- doses maint 500 mg PO qid Feds. Initial 40-60 mg/kg/24 h PO -s- q4-6h maint 20-30 mg/kg/24 h PO q6h RA >6 y 30-50 mg/kg/d in 2 doses, start w/ 1/4-1/3 maint dose, T wkly until dose reached at 1 mo, 2 g/d max -i in renal failure... 

Sulfasalazine, commonly used in the treatment of inflammatory bowel disease and rheumatoid arthritis, is selectively used as an alternative treatment, particularly in patients with concurrent psoriatic arthritis. Sulfasalazine is an anti-inflammatory agent that inhibits 5-lipoxygenase. When used as a single agent in the treatment of psoriasis, it is not as effective as is therapy with methotrexate, PUVA, or acitretin. One possible advantage of sulfasalazine therapy compared with other systemic treatments is its relatively high margin of safety. The usual dose of oral sulfasalazine is 3 to 4 g/day for 8 weeks. ... 

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