Unlocking sulfasalazine's mechanism of action in IBD-SpA patients

[Sly Saint]

Although it is one of the oldest medications used to treat patients with inflammatory bowel disease (IBD) and an effective treatment for an associated arthritis condition called spondyloarthritis (SpA), sulfasalazine's mechanism of action has been unclear. Now researchers at the Jill Roberts Center for IBD and the Jill Roberts Institute for Research in IBD at Weill Cornell Medicine and NewYork-Presbyterian have determined that the drug works by modulating the activity of a group of gut bacteria that are more abundant in patients who respond to the drug. These findings solve a long-standing question of how and why sulfasalazine is effective for some people, but not all, and could lead to advances in treating IBD.

In a study published Feb. 19 in Cell Reports Medicine, researchers examined IBD-SpA patients treated with sulfasalazine and found that the presence of the gut bacterium Faecalibacterium prausnitzii was a key factor enabling successful treatment responses. They determined that sulfasalazine works by upregulating this bacterium's production of butyrate, a fatty acid molecule with anti-inflammatory properties.

..
IBD frequently coexists with SpA, and sulfasalazine reduces or eliminates symptoms of both conditions in many of these patients. Prior studies have suggested that it works via the gut microbiome, though the precise mechanism has never been clear.

Unlocking sulfasalazine's mechanism of action in IBD-SpA patients (msn.com)

 

[Jonathan Edwards]

The story does not sound particularly convincing but I wonder if anyone has tried sulphasalazine for ME/CFS?

It might work, and maybe for a completely different reason. It is reasonably safe apart from early neutropenia in a few cases and, very rarely, hypogammaglobulinemia. I am not suggesting anyone tries it but it would be interesting to know if there are any existing data.

 

[Kitty]

I wonder if anyone has tried sulphasalazine for ME/CFS? ... I am not suggesting anyone tries it but it would be interesting to know if there are any existing data.

It would be great to know, but it'd probably need a specific study.

I've been on it for more than a decade for psoriatic arthritis. I responded very well, and I think my ME/CFS has been more stable too.

But if the effect is there at all, it's a smoothing of the graph line, a reduction in how far up and down the Y axis it jumps. My graph could be mistaken for that of someone who'd started pacing conscientiously (a thing I've never managed).

 

[NelliePledge]

It would be great to know, but it'd probably need a specific study.

I've been on it for more than a decade for psoriatic arthritis. I responded very well, and I think my ME/CFS has been more stable too.

But if the effect is there at all, it's a smoothing of the graph line, a reduction in how far up and down the Y axis it jumps. My graph could be mistaken for that of someone who'd started pacing conscientiously (a thing I've never managed).

That is interesting

 

[Art Vandelay]

The story does not sound particularly convincing but I wonder if anyone has tried sulphasalazine for ME/CFS?

Some decades ago, a gastroenterologist (who is a bit of a maverick) prescribed it for me after a colonoscopy showed mild inflammation and, subsequently, a parasite infection. I was mainly complaining of nausea and cramping. He claimed it would help mainly with nausea I think.

It didn't have any effect on any of my symptoms (gut or otherwise).