Pullar T, Hunter J A, Capell H A
Br J Rheumatol. 1985 Aug;24(3):269-76. doi: 10.1093/rheumatology/24.3.269.
Previous studies of sulphasalazine in rheumatoid arthritis have chosen an empirical dose based upon its use in ulcerative colitis. In this study we compare the efficacy and toxicity of two doses (1.5 g/day and 3 g/day, 30 patients per group), and attempt to relate efficacy to serum levels of sulphasalazine and its metabolites. After six months 24 of the low-dose group and 20 of the high-dose group remained on treatment. Greater improvement was seen in the high-dose group. When dose was expressed as mg/kg, the dose efficacy ratio became more apparent and a dose of greater than 40 mg/kg/day appears to confer greater benefit. No relationship was demonstrated between serum levels of sulphasalazine or its measured metabolites, and efficacy. We conclude that response to sulphasalazine in rheumatoid arthritis is dose dependent but does not relate to serum levels of sulphasalazine, sulphapyridine, or acetyl sulphapyridine.
以往关于柳氮磺胺吡啶治疗类风湿关节炎的研究，是根据其在溃疡性结肠炎中的应用来选择经验性剂量的。在本研究中，我们比较了两种剂量（1.5克/天和3克/天，每组30例患者）的疗效和毒性，并试图将疗效与柳氮磺胺吡啶及其代谢产物的血清水平联系起来。六个月后，低剂量组有24例患者、高剂量组有20例患者仍在接受治疗。高剂量组的改善更为明显。当剂量以毫克/千克表示时，剂量-疗效比更为明显，大于40毫克/千克/天的剂量似乎能带来更大益处。柳氮磺胺吡啶及其代谢产物的血清水平与疗效之间未显示出相关性。我们得出结论，类风湿关节炎患者对柳氮磺胺吡啶的反应是剂量依赖性的，但与柳氮磺胺吡啶、磺胺吡啶或乙酰磺胺吡啶的血清水平无关。
