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Azulfidine

Generic Azulfidine is used for the treatment of mild to moderate ulcerative colitis, as adjunctive therapy (with other medications) in the treatment of severe ulcerative colitis, for the treatment of Crohn's disease, for the treatment of rheumatoid arthritis or ankylosing spondylitis.

Other names for this medication:
Azulfidina, Salazopyrin, Sulazine, Sulfazine

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Also known as:  Sulfasalazine.

Description

Generic Azulfidine is used for the treatment of mild to moderate ulcerative colitis, as adjunctive therapy (with other medications) in the treatment of severe ulcerative colitis, for the treatment of Crohn's disease, for the treatment of rheumatoid arthritis or ankylosing spondylitis.

Generic Azulfidine is a sulfonamide that decreases inflammation and help regulate the immune system in various areas of the body.

Azulfidine is also known as Sulfasalazine.

Generic name of Generic Azulfidine is Sulfasalazine.

Brand name of Generic Azulfidine is Azulfidine.

Dosage

Doses range: from 500 mg to 2000 mg, and dosing intervals range: from every 6 hours to every 12 hours, depending on the clinical condition of the patient.

Generic Azulfidine should be taken with a full glass of water after meals or with food to minimize stomach upset.

Patients with kidney diseases may need to use lower doses of Generic Azulfidine.

If you want to achieve most effective results do not stop taking Generic Azulfidine suddenly.

Overdose

If you overdose Generic Azulfidine and you don't feel good you should visit your doctor or health care provider immediately.

Storage

Store at room temperature between 15 and 30 degrees C (59 and 86 degrees F) away from moisture and heat. Keep container tightly closed. Throw away any unused medicine after the expiration date. Keep out of the reach of children.

Side effects

The most common side effects associated with Azulfidine are:

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Side effect occurrence does not only depend on medication you are taking, but also on your overall health and other factors.

Contraindications

Do not take Generic Azulfidine if you are allergic to Generic Azulfidine components or to a salicylate (eg, aspirin) or a sulfonamide (eg, sulfisoxazole).

Be veru careful with Generic Azulfidine if you are pregnant, planning to become pregnant or breast-feeding.

Do not take Generic Azulfidine if you have the blood disease porphyria or a blockage of the intestine or urinary tract.

Some medical conditions may interact with Generic Azulfidine.

Be veru careful with Generic Azulfidine if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement.

Be veru careful with Generic Azulfidine if you have allergies to medicines, foods, or other substances.

Be veru careful with Generic Azulfidine if you have kidney or liver problems, a blood disorder, a gastrointestinal infection, glucose-6-phosphate dehydrogenase deficiency, or asthma.

Some medicines may interact with Generic Azulfidine.

Be veru careful with Generic Azulfidine if you are taking anticoagulants (eg, warfarin) or methotrexate because the actions and side effects of these medicines may be increased; anticoagulants (eg, warfarin) or beta-blockers (eg, propranolol) because their effectiveness may be decreased by Generic Azulfidine; methenamine because the risk of crystals in the urine is increased.

Do not share this medicine with others for whom it was not prescribed.

Do not use this medicine for other health conditions.

If using this medicine for an extended period of time, obtain refills before your supply runs out.

It can be dangerous to stop Generic Azulfidine taking suddenly.

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Continuation or discontinuation of drugs during pregnancy in chronic diseases is an issue of concern. Information on prescribing of disease modifying anti-rheumatic drugs (DMARDs) during pregnancy is scarce. In this study, we report prescribing patterns round pregnancy of sulfasalazine (SSZ), azathioprine (AZA), methotrexate (MTX) and co-medications among women to whom one of these DMARDs were prescribed before pregnancy.

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Free radicals and reactive oxygen metabolites have been implicated as important pathologic mediators in many clinical disorders and diseases. An efficient method of detecting the free radical scavenger effect is through xanthine oxidase (XO) inhibition. The inhibition efficiency on XO has been detected as the rate of uric acid production, which has max 295 nm. Sulfasalazine showed potent inhibiting activity on XO (IC50 = 25.11 microM; Ki = 50.88 microM) and induced a mixed-type (non-competitive-uncompetitive) inhibition of the substrate xanthine. 2-mercapto-4(3H)-quinazolinone (16) and 2-mercaptopyrimidine (4) displayed inhibiting activity on XO with IC50 = 98.71 and 136.14 microM, while apparent inhibition constants (Ki) were 158.38 and 62.46 microM, respectively. However benzotriazoles showed weak inhibitory effect. The spin-trapping method with 5,5-dimethyl-1-pyrroline N-oxide (DMPO) by electron spin resonance (ESR) detected the presence of O2-* and OH*. It showed that the percentage inhibition for formation of DMPO-OOH for 2-mercapto-pyrimidine and sulfasalazine were 64.78 and 35.09, but for hydroxylation were 49.51, 38.55, 37.29 for 2-mercapto-4(3H)-quinazolinone, sulfasalazine and 2-mercaptopyrimidine at 500 microM, respectively.

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Not uncommonly, some children with systemic-onset juvenile rheumatoid arthritis (JRA) have persistently active disease with joint destruction and profound growth delay despite maximum treatment with known medications. Based on previous observations of improvement in synovitis following intravenous (I.V.) cyclophosphamide (CYC) and methylprednisolone (MP) treatments, a group of children with severe systemic-onset JRA was treated in an attempt to control active synovitis and to allow tapering of corticosteroids.

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We report two young men with clinical and laboratory evidence of macroscopic ulcerative colitis, sclerosing cholangitis, and insulin-dependent diabetes mellitus. The first patient presented at age 15 with vomiting, abdominal pain, weight loss, and abnormal liver function test results. Liver biopsy and endoscopic retrograde cholangiopancreatography (ERCP) demonstrated sclerosing cholangitis. Colonoscopy with biopsy revealed ulcerative colitis which responded to sulfasalazine. Diabetes occurred at age 18 and insulin therapy was begun. The second patient was 19 at presentation with diarrhea, hematochezia, and weight loss. Proctosigmoidoscopy revealed ulcerative colitis, and sulfasalazine led to clinical remission. Three months later he developed diabetes requiring insulin therapy. At age 28, he developed elevated alkaline phosphatase, and ERCP revealed sclerosing cholangitis. At age 37 he expired from adenocarcinoma that metastasized to the liver. Literature review revealed only one possible case report of this association with microscopic asymptomatic ulcerative colitis in that patient. Statistical analysis suggests that this association is real rather than a chance occurrence. An autoimmune process may be involved and a specific histocompatibility locus antigen (HLA) type may exert a regulatory influence.

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Crude incidence rates [95 % confidence interval (CI)] of acute pancreatitis among patients on MMX mesalazine were similar to those of patients on comparator therapies [8.55 (5.54-13.21) vs 10.05 (7.54-13.41) per 1000 person-years]; the resulting incidence rate ratio (IRR) was [0.85 (0.48-1.47)]. Propensity score-matching had little influence on the IRR [0.84 (0.46-1.55)]; nor did further adjustment by demographic characteristics, daily dose, and causes of acute pancreatitis [0.76 (0.41-1.43)].

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Thirty children less than 15 years of age with Crohn's disease are reported. The mean age of onset was nine years and five months. Delay in diagnosis may stem from the varying modes of presentation. The mean delay in diagnosis was two years. Chronic diarrhea and/or recurrent abdominal pain associated with extraintestinal manifestations, particularly abnormalities of growth and development suggests the possibility of Crohn's disease in the pediatric age group. Involvement of the terminal ileum occurred in 29 of the 30 patients. In addition, colonic disease occurred in 13 and jejunal involvement in one. Four patients presented with an acute onset of their disease. A favorable response to either medical or surgical therapy occurred in all four. Twenty-six patients had an insidious onset and tended to have a chronic course despite either medical and/or surgical therapy. Thirteen patients had an intestinal resection, with recurrence occurring in three from 1-4 years postoperatively. To date there has been one death.

azulfidine dose ulcerative colitis

From the compendium presented above, the following statements become evident: 1) Inappropriately low secretion of cortisol in relation to inflammation is a typical feature of the inflammatory disease in patients with RA. 2) The secretion of adrenal androgens is significantly reduced, which is a problem in postmenopausal women and elderly men due to a lack of downstream sex hormones. 3) Serum levels of testosterone are markedly reduced in RA. 4) Sympathetic nerve fibers are markedly reduced in the synovial tissue of patients with RA, whereas proinflammatory sensory fibers (substance P) are present. 5) Substance P serves to continuously sense painful stimuli in the periphery, and the nociceptive input from the inflamed joint shows a large amplification in the spinal cord. This leads to continuous pain with stabilization of the afferent sensory input and continuous release of proinflammatory substance P into the lumen of the joint. From these facts it is obvious that alterations of the systemic antiinflammatory feedback systems contribute significantly to the pathogenesis of RA. Disease therapy directed at these alterations must provide a mechanism to replace the adrenal glands (glucocorticoids), the gonadal glands (androgens), and the sympathetic nervous system (adenosine increase by low-dose MTX, sulfasalazine, and salicylates) in order to integrate their immunosuppressive effects at the local site of synovial inflammation. Although local processes of the adaptive immune system are important in pathogenesis in the acute phase of RA, these mechanisms may be less important during the chronic phase of the disease in the absence of a specific trigger. We believe that a defect of systemic antiinflammatory feedback systems is an important factor in the perpetuation of RA. This review reinforces the belief that combined therapeutic approaches on a neuroendocrine immune basis are of crucial importance in a pathogenetically oriented therapy of RA.

azulfidine dosage rheumatoid arthritis

To compare patterns and time trends of initial disease-modifying antirheumatic drugs (DMARDs) and prednisolone prescriptions for patients with rheumatoid arthritis (RA) by the rheumatologists at King Chulalongkorn Memorial Hospital, Bangkok, Thailand over a 15-year period, as well as their side effects.

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Sulphasalazine (SASP) has recently become established as an effective treatment for active rheumatoid arthritis (RA), but has not previously been used in psoriatic arthritis in which remission-inducing drugs have proved disappointing. In this one year open study, 34 patients with active psoriatic arthritis were treated with sulphasalazine. An overall favourable clinical response was observed in 23 patients (67%). Nine patients (26%) achieved a very good therapeutic response and these either had arthritis associated with spondylitis or the symmetrical type of joint disease. Evaluation at 3, 6 and 12 months showed a significant improvement in inflammatory indices including a reduction in the C-reactive protein level and ESR. The drug was well-tolerated and side-effects were mild. Eight patients (23.5%) stopped the drug because of reactions and one patient with a rash was successfully desensitised. Fifty-three percent continued the drug into the second year. No apparent exacerbation of the psoriasis was observed. These results suggest that sulphasalazine is a safe and potentially effective drug in the treatment of psoriatic arthritis. A double-blind placebo-controlled trial has been set up to determine its true efficacy.

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A prospective study was undertaken to establish the role of individualized diet counselling in the management of 137 outpatients with Crohn's disease. Individualized dietary counselling for 6 months was associated with a significant decrease in the Crohn's disease activity index, an increased incidence of disease remission, a decreased need for prednisone and Salazopyrin therapy, a reduction in the number of days spent in hospital, and a reduction in the amount of time lost from work due to Crohn's disease, when compared with control patients who did not receive dietary counselling but who were seen regularly in follow-up under similar circumstances. Improvement with diet counselling was more likely to occur in patients who had not previously been subjected to small bowel resection, and occurred in patients with active or inactive disease. The effect of counselling 58 patients was assessed over a further 6 months (for a total 12-month period); there was a persistently reduced Crohn's disease activity index and a continued decreased number of lost days of work. The mechanism for these beneficial effects of diet counselling was not established. It is suggested that individualized diet counselling, aimed at optimizing the patient's nutritional status, may play a role in the management of patients with Crohn's disease.

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Ankylosing spondylitis (AS) is a systemic inflammatory rheumatic disease involving spinal and sacroiliac joints. This condition is responsible for back pain, stiffness and discomfort. Several drugs are currently available in the management of AS, and may be divided into 3 groups. The first includes nonsteroidal anti-inflammatory drugs (NSAIDs), which are the main drug group used in AS because they reduce pain and stiffness in most patients. Several NSAIDs are available but phenylbutazone is considered the NSAID of choice in AS. However, other NSAIDs give similar beneficial results and the medication of preference in specific to each patient. All NSAIDs share common gastrointestinal toxicity, and they should be administered during periods of flare-up of the disease. The second drug group that has been used in the treatment of patients with AS comprises analgesics, muscle relaxants and low dose corticosteroids. They can be considered as adjuvant therapy. These drugs are helpful when NSAIDs are poorly tolerated or ineffective. Second-line treatments or disease modifying antirheumatic drugs (DMARDs) are included in the third group. These drugs are required in cases of longstanding severe or refractory AS. Sulfasalazine has proven to be effective in such cases, leading to improvement in clinical and laboratory indices of disease activity. Beneficial results are mainly evident in patients with AS who have peripheral disease involvement. Other medications (such as methotrexate or gold salts, for instance) require properly designed controlled studies to evaluate their effectiveness in the treatment of this disorder, while immunosuppressive agents have little to offer in the management of patients with AS and require further studies. Some specific clinical features are observed in AS: enthesopathy may be treated with local injection of corticosteroids; sacroiliac joint pain may be managed by corticosteroid injection performed under fluoroscopic control or guided by computed tomography. The management of patients with AS includes some other procedures such as patient education, rest, a programme of physical exercise and physiotherapy. In parallel with pharmacotherapy, these procedures are of great importance in reducing stiffness and spinal ankylosis, and thus improve the patient's quality of life.

azulfidine sulfasalazine dosage

Momordica charantia is used to treat various diseases, including inflammatory conditions. Previous reports indicated that the extract of this plant inhibits activation of nuclear transcription factor-κB (NF-κB) but activates peroxisome proliferator-activated receptor (PPAR). Additionally, cucurbitane-type triterpene glycosides are the main bioactive components of the fruit of M. charantia. Therefore, we investigated the anti-inflammatory activity of 17 cucurbitane-type triterpene glycosides (1-17) isolated from this plant. Their inhibition of NF-κB and activation of PPAR activities in HepG2 cells were measured using luciferase reporter and PPAR subtype transactivation assays. Compounds 6 and 8 were found to inhibit NF-κB activation stimulated by tumor necrosis factor-α (TNFα) in a dose-dependent manner. With 50% inhibition concentration (IC(50)) values of 0.4 μM, compounds 6 and 8 were more potent inhibitors than the positive control, sulfasalazine (IC(50)=0.9 μM). Compounds 4, 6, and 8 also inhibited TNFα-induced expressions of inducible nitric oxide synthase and cyclooxygenase-2 mRNA. However, only compound 13 significantly increased PPARγ transactivation.

azulfidine ra 500 mg

This paper reviews our five years' clinical experience (1987 to 1991) of 22 patients with inflammatory bowel disease (IBD). There were 12 patients with Crohn's disease and 10 patients with ulcerative colitis. The mean age at diagnosis was 8.7 years (2 to 14 years). Clinical impressions before referral were chronic diarrhea in 11, irritable bowel syndrome in 5, colon polyp in 4, lymphoma in 3, intestinal tuberculosis in 2, amoebic colitis in 2, ulcerative colitis in 2 children and other diseases. The mean interval from the onset of symptoms to the diagnosis of IBD was 18 months. Diagnosis of Crohn's disease was delayed for more than 13 months in 8 (67%), whereas that of ulcerative colitis was delayed for more than 13 months in 4 (40%). Diarrhea (50%), abdominal pain (36%) and rectal bleeding (36%) were the three most frequent presenting complaints of IBD. Moderately severe abdominal pain was a more common chief complaint in Crohn's disease (58%) than in ulcerative colitis (10%). Hematochezia (90% vs 17%) and moderately severe diarrhea (90% vs 75%) were more common gastrointestinal manifestations in ulcerative colitis than in Crohn's disease. The associated extraintestinal manifestations were oral ulcer in 7, arthralgia in 11 and arthritis in 4, skin lesions in 2, eye lesions in 2 and growth failure in 9 patients. Of 12 children with Crohn's disease, granuloma was found in 5, aphthous ulcerations in 8, cobble stone appearance in 8, skip area or asymmetric lesions in 6, transmural involvement in 7, and perianal fistula in 3. Among 10 children with ulcerative Colitis, there were crypt abscess in 8, granularity or friability in 10 and rectosigmoid ulcerations with purulent exudate in 8 children. The main sites of involvement in children with Crohn's disease were both the small and large bowels in 7 (58%), small bowel only in 2 (16%), and colon only in 3 (25%). Terminal ileum involvement was seen in 75% of Crohn's disease cases. The main sites of involvement in children with ulcerative colitis were total colon in 4 (40%), up to the splenic flexure in 2 (20%), rectosigmoid in 3 (30%) and rectum only in one (10%). Medical treatment including sulfasalazine, and systemic or topical steroid was administered initially in most patients. Seven of 12 patients with Crohn's disease and 2 of 10 patients with ulcerative colitis were operated on.(ABSTRACT TRUNCATED AT 400 WORDS)

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Eight week randomised double blind parallel group study.

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azulfidine prices usa 2015-04-28

Currently available therapeutic agents for the treatment of rheumatoid arthritis are unsatisfactory for many patients, due either to inefficacy, loss of effectiveness with time, or toxicity. One approach is to study drugs in combination, at lower than usual dosages of each, in order to achieve greater efficacy with fewer adverse reactions. To aid in this review of published Dosage Nexium 40 Mg trials, the various combinations have been arbitrarily divided into combinations of cytotoxic (antiproliferative) drugs with each other, and combinations of noncytotoxic drugs. Of the noncytotoxic combinations, intramuscular gold with D-penicillamine appeared to offer the best results without increased side effects when compared to each one used alone. The most promising cytotoxic combination was methotrexate with azathioprine.

azulfidine reviews 2016-07-21

The patient recovered after treatment discontinuation and did not exhibit any recurrence of pericarditis when treatment Colchicine Drug Interaction Motrin with mesalazine was introduced.

azulfidine 500 mg pfizer 2017-06-13

Ileocolonoscopy on patients with HLA-B27 related disease, reactive arthritis and ankylosing spondylitis (AS) with peripheral arthritis, revealed the presence of inflammatory lesions in biopsy specimens from the Zithromax Bottles Of 18 Capsules ileum in 71 and 60% of the cases, respectively. A 2nd ileocolonoscopy was performed on 14 patients, 4 to 22 months after the first. In 6 of the 7 patients in articular clinical remission, the inflammatory gut lesions had disappeared. The gut biopsies of the 7 patients with active joint disease continued to show inflammatory lesions. One of these patients underwent a 3rd ileocolonoscopy after having gone into clinical remission, possibly secondary to treatment with sulfasalazine; the histology was completely normal. The strong relationship between clinical articular inflammation and gut inflammation seems to support the hypothesis that in B27 related diseases, repetitive exogenous triggering causing transgression of oral tolerance by increased gut permeability, provokes and maintains the joint inflammation.

azulfidine drug 2016-06-10

This article reviews the use of conventional disease-modifying antirheumatic drugs (DMARDs) in the treatment of early rheumatoid arthritis (RA). The Finnish early RA cohorts are used as examples of how early and active treatment strategies have improved over time with increasing variety of available DMARDs. Therapy goals of early RA include remission to prevent severe long-term outcomes of RA. Remission can be achieved in a third of patients with early RA using a combination of conventional DMARDs, including methotrexate Omnicef Peds Dosing , sulfasalazine, hydroxychloroquine, and prednisolone. Of patients with early RA, 20% to 30% do not improve enough with conventional treatments and should be identified at early phases to consider institution of biologic agents.

azulfidine 500mg tablet 2015-07-08

This report Tricor Drug Class describes two patients who developed severe neutropenia one month after starting sulphasalazine (SASP) as treatment for their inflammatory joint disease. Both recovered on stopping the drug. Six further cases (out of a series of 180 patients with inflammatory forms of arthritis receiving SASP therapy) in whom transient leucopenia occurred are also recorded. These patients were able to continue the drug under close supervision. Sulphasalazine is a useful addition to the small number of slow acting antirheumatic drugs (SAARDs) and, despite this complication, is safer than other SAARDs. Careful monitoring of patients is essential, however, particularly in the early stages of treatment, to detect this adverse reversible reaction promptly.

azulfidine suspension 2017-08-07

Nitric oxide production was partly (< or = 50%) inhibited and IL-8 almost completely suppressed (> 80%) by dexamethasone and methylprednisolone. Sulfasalazine in pharmacological concentration and indomethacin Duphaston Pills During Pregnancy slightly increased IL-8. No effect of methotrexate on nitric oxide or IL-8 production was found.

azulfidine brand 2017-12-18

Induction of enteritis resulted in significant increase of disease activity index, significant elevation of serum levels of C-reactive Cluster Headaches Prednisone Dose protein and tumor necrosis factor-α, significant deterioration of pathological scores and significant increase in the mean contractility response of the isolated ileal segments compared with normal untreated rats. Treatment with sulfasalazine, low dose of natrexone or their combination resulted in significant improvement of all measured parameters compared with enteritis group.

azulfidine ra 500 mg 2015-10-01

FAVORABLE PROGNOSIS: The prognosis of systemic Zyrtec Tablet During Pregnancy onset juvenile idiopathic arthritis varies. The most favorable outcome is observed when joint involvement is mild or delayed. No initial clinical or biological feature is indicative of severe prognosis except polyarticular involvement at onset. There is no HLA association. After 10 years follow-up, inflammatory features have disappeared in 50% of the cases, with some disability in 25%.

azulfidine en tabs 500mg 2016-12-05

The function of the intestinal microflora was studied in patients with ulcerative colitis before and after colectomy. The following six microflora-associated characteristics (MACs) were investigated: formation of coprostanol and urobilinogen; degradation of mucin, water-soluble protein, and beta-aspartylglycine; and presence of faecal tryptic activity. In 12 unoperated patients without sulphasalazine as maintenance therapy the six MACs were similar to those in normal subjects. In 12 unoperated patients receiving sulphasalazine the formation of coprostanol and urobilinogen was significantly lower (p less than 0.01 and p less than 0.001, respectively) and the level of faecal tryptic activity was significantly higher (p less than 0.01) than in normal subjects. The functional capacity of the microflora in operated patients treated by colectomy combined with one of four surgical procedures (ileorectal anastomosis, ileoanal anastomosis with pelvic pouch, Kock' Research Cost Of Viagra s continent ileostomy, or conventional ileostomy) was disturbed with regard to all six MACs. The disturbance was most pronounced in patients with conventional ileostomy.

dosage of azulfidine 2016-12-19

Adverse events recorded were three Zanaflex 10 Mg instances of gastrointestinal disturbance and one flare of RA. Plasma and urinary levels of SSZ and its metabolites showed no statistically significant changes after probiotic administration and the incidence of gastrointestinal disturbance did not appear to be ascribed to higher sulfapyridine plasma levels. Probiotic-specific DGGE bands were detected in the feces of some patients after the treatment period.

azulfidine 500 mg tab 2015-12-19

The influence of inflammatory bowel disease (IBD) and its therapy upon pregnancy is a frequent consideration before and after conception. We looked at the influence of disease activity and drug therapy during pregnancy on fetal outcome in 147 pregnancies in 124 women. Patients were divided into two groups; 46 (28 ulcerative colitis, 18 Crohn's disease) who received drug treatment during pregnancy, and 101 (42 ulcerative colitis, 59 Crohn's disease) who received no treatment. The frequency of fetal complications was higher than in the general population in the "treated" patients, but was not higher than in patients with IBD who received no drug treatment. Active IBD was present in 43% of the treated patients whose pregnancies resulted in fetal complications. Of patients with Crohn's disease whose pregnancies resulted in fetal complications, active IBD was present in 62.5%. Thus, our experience suggests that patients with IBD who receive therapy during pregnancy are at greater risk of fetal complications than the average population, but that disease activity is more likely to be responsible for this risk than drug treatment. This risk is much more evident in active Crohn's disease than in ulcerative colitis.

azulfidine sulfasalazine dosage 2017-01-29

Both groups showed substantial improvements in disease activity and functional outcome. At 12 months, the mean decrease in the DAS28 score was -4.0 (step-up therapy group) versus -3.3 (parallel therapy group) (P = 0.163). No significant differences in the percentages of patients with DAS28 remission (step-up therapy group 45% versus parallel triple therapy group 33%), DAS28 good response (60% versus 41%, respectively), or American College of Rheumatology criteria for 20% improvement (ACR20) (77% versus 76%, respectively), ACR50 (60% versus 51%, respectively), or ACR70 (30% versus 20%, respectively) responses were seen. Radiologic progression was similar in both groups.