Home LiteratureArticle Details
PMID: 1973396 Published · ppublish English Journal Article

Treatment of non-steroidal anti-inflammatory drug induced enteropathy.

Gut ·Vol. 31 ·No. 7 ·1990-07-00 ·Pages 777-80

Bjarnason I, Hopkinson N, Zanelli G, Prouse P, Smethurst P, Gumpel JM, Levi AJ

Abstract

Non-steroidal anti-inflammatory drug induced small intestinal inflammation may have an adverse effect on the joints of patients with rheumatoid arthritis. We therefore assessed small intestinal and joint inflammation in patients with rheumatoid arthritis before and after three to nine months' treatment with sulphasalazine (n = 40) and other second line drugs (n = 20), while keeping the dosage of non-steroidal anti-inflammatory drug at the same level. Sulphasalazine significantly decreased the mean (SD) faecal excretion of 111indium labelled leucocytes from 2.39 (2.22)% to 1.33 (1.13)% (normal less than 1%, p less than 0.01) and improved the joint inflammation as assessed by a variety of parameters. There was no significant correlation between the effects of sulphasalazine treatment on the intestine and the joints. Treatment with other second line drugs had no significant effect on the faecal excretion of 111indium (1.58 (1.04)% and 1.86 (1.51)%, respectively) but improved joint inflammation significantly. The lack of correlation between the intestinal and joint inflammation and their response to treatment suggests that the two are not causally related.

MeSH Terms
Adult Aged Anti-Inflammatory Agents, Non-Steroidal/adverse effects Arthritis, Rheumatoid/drug therapy Enteritis/chemically induced,drug therapy Female Humans Male Middle Aged Sulfasalazine/therapeutic use
Chemicals
Anti-Inflammatory Agents, Non-Steroidal Sulfasalazine
Authors & Affiliations
7 authors, click to expand affiliations / ORCID
Bjarnason I
Section of Gastroenterology, MRC Clinical Research Centre, Harrow, Middlesex, United Kingdom.
Hopkinson N
Zanelli G
Prouse P
Smethurst P
Gumpel J M
Levi A J
References (45)
45 references, click to expand
  1. Sequential studies in ankylosing spondylitis. Association of Klebsiella pneumoniae with active disease.
    Ann Rheum Dis. 1978 Apr;37(2):146-51 PMID: 348130
  2. Reactive arthritis associated with Campylobacter jejuni enteritis.
    Br Med J. 1979 Feb 10;1(6160):380-1 PMID: 761021
  3. Klebsiella pneumoniae and acute anterior uveitis in ankylosing spondylitis.
    Br Med J. 1979 Feb 10;1(6160):383 PMID: 367506
  4. National Cooperative Crohn's Disease Study: results of drug treatment.
    Gastroenterology. 1979 Oct;77(4 Pt 2):847-69 PMID: 38176
  5. Effect of fasting and lactovegetarian diet on rheumatoid arthritis.
    Scand J Rheumatol. 1979;8(4):249-55 PMID: 534318
  6. A simple index of Crohn's-disease activity.
    Lancet. 1980 Mar 8;1(8167):514 PMID: 6102236
  7. Sulphasalazine in rheumatoid arthritis.
    Br Med J. 1980 Feb 16;280(6212):442-4 PMID: 6102877
  8. An "experimental" epidemic of Reiter's syndrome.
    JAMA. 1966 Nov 14;198(7):693-8 PMID: 5953323
  9. Small intestinal ulcers and intestinal flora in rats given indomethacin.
    Am J Pathol. 1969 Feb;54(2):237-49 PMID: 5765565
  10. 111Indium autologous leucocytes in inflammatory bowel disease.
    Gut. 1983 Apr;24(4):293-9 PMID: 6832626
  11. Comparison between penicillamine and sulphasalazine in rheumatoid arthritis: Leeds-Birmingham trial.
    Br Med J (Clin Res Ed). 1983 Oct 15;287(6399):1099-102 PMID: 6138116
  12. Quantitative fecal indium 111-labeled leukocyte excretion in the assessment of disease in Crohn's disease.
    Gastroenterology. 1983 Dec;85(6):1333-9 PMID: 6628930
  13. European Cooperative Crohn's Disease Study (ECCDS): results of drug treatment.
    Gastroenterology. 1984 Feb;86(2):249-66 PMID: 6140202
  14. Intestinal permeability and inflammation in rheumatoid arthritis: effects of non-steroidal anti-inflammatory drugs.
    Lancet. 1984 Nov 24;2(8413):1171-4 PMID: 6150232
  15. NSAID and the leaky gut.
    Lancet. 1985 Jan 26;1(8422):218-9 PMID: 2857287
  16. Sulphasalazine: a safe, effective agent for prolonged control of rheumatoid arthritis. A comparison with sodium aurothiomalate.
    Ann Rheum Dis. 1985 Mar;44(3):194-8 PMID: 2858182
  17. Which component of sulphasalazine is active in rheumatoid arthritis?
    Br Med J (Clin Res Ed). 1985 May 25;290(6481):1535-8 PMID: 2860942
  18. HLA-B27 related arthritis and bowel inflammation. Part 2. Ileocolonoscopy and bowel histology in patients with HLA-B27 related arthritis.
    J Rheumatol. 1985 Apr;12(2):294-8 PMID: 3875721
  19. Indium 111-granulocyte scanning in the assessment of disease extent and disease activity in inflammatory bowel disease. A comparison with colonoscopy, histology, and fecal indium 111-granulocyte excretion.
    Gastroenterology. 1986 May;90(5 Pt 1):1121-8 PMID: 3956932
  20. Preliminary evidence for gut involvement in the pathogenesis of rheumatoid arthritis?
    Br J Rheumatol. 1986 May;25(2):162-6 PMID: 3085760
  21. 111Indium-labelled polymorphonuclear leucocyte scans in rheumatoid arthritis--an important clinical cause of false positive results.
    Br J Rheumatol. 1986 May;25(2):167-70 PMID: 3708233
  22. 5-Aminosalicylic acid or sulphapyridine. Which is the active moiety of sulphasalazine in rheumatoid arthritis?
    Drugs. 1986;32 Suppl 1:27-34 PMID: 2877851
  23. Effect of non-steroidal anti-inflammatory drugs and prostaglandins on the permeability of the human small intestine.
    Gut. 1986 Nov;27(11):1292-7 PMID: 3466837
  24. Increased intestinal permeability in patients with rheumatoid arthritis: a side-effect of oral nonsteroidal anti-inflammatory drug therapy?
    Br J Rheumatol. 1987 Apr;26(2):103-7 PMID: 3103807
  25. Nonsteroidal antiinflammatory drug-induced intestinal inflammation in humans.
    Gastroenterology. 1987 Sep;93(3):480-9 PMID: 3609658
  26. HLA antigens in seronegative spondylarthropathies. Reactive arthritis and arthritis in ankylosing spondylitis: relation to gut inflammation.
    J Rheumatol. 1987 Jun;14(3):466-71 PMID: 3498033
  27. Blood and protein loss via small-intestinal inflammation induced by non-steroidal anti-inflammatory drugs.
    Lancet. 1987 Sep 26;2(8561):711-4 PMID: 2888943
  28. Helping the mucosa make sense of macromolecules.
    Gut. 1987 Sep;28(9):1057-61 PMID: 3315879
  29. Clinicopathological features of nonsteroidal antiinflammatory drug-induced small intestinal strictures.
    Gastroenterology. 1988 Apr;94(4):1070-4 PMID: 3345876
  30. Sulfasalazine: I. An historical perspective.
    Am J Gastroenterol. 1988 May;83(5):487-96 PMID: 2896458
  31. Sulfasalazine: II. Some notes on the discovery and development of salazopyrin.
    Am J Gastroenterol. 1988 May;83(5):497-503 PMID: 2896459
  32. Diaphragm disease: pathology of disease of the small intestine induced by non-steroidal anti-inflammatory drugs.
    J Clin Pathol. 1988 May;41(5):516-26 PMID: 3384981
  33. Molecular biology of the HLA-B27 locus.
    Br J Rheumatol. 1988;27 Suppl 2:12-8 PMID: 3042071
  34. Acute anterior uveitis and faecal carriage of gram-negative bacteria.
    Br J Rheumatol. 1988;27 Suppl 2:42-5 PMID: 3261190
  35. Molecular mimicry: fact or fiction?
    Br J Rheumatol. 1988;27 Suppl 2:55-7 PMID: 3042076
  36. Klebsiella antibodies in ankylosing spondylitis and Proteus antibodies in rheumatoid arthritis.
    Br J Rheumatol. 1988;27 Suppl 2:72-85 PMID: 3042077
  37. Ileocolonoscopic findings in seronegative spondylarthropathies.
    Br J Rheumatol. 1988;27 Suppl 2:95-105 PMID: 3042080
  38. Arthritis associated with Salmonella infections.
    Ann Rheum Dis. 1970 Sep;29(5):483-7 PMID: 5476675
  39. The primary cause of rheumatoid arthritis is an infection--the infectious agent exists in milk.
    Acta Med Scand. 1972 Sep;192(3):231-9 PMID: 4560118
  40. Arthritis and Crohn's disease. A family study.
    Ann Rheum Dis. 1973 Nov;32(6):479-86 PMID: 4760472
  41. Uptake and transport of macromolecules by the intestine. Possible role in clinical disorders.
    Gastroenterology. 1974 Sep;67(3):531-50 PMID: 4137347
  42. HL-A 27 in reactive arthritis. A study of Yersinia arthritis and Reiter's disease.
    Arthritis Rheum. 1974 Sep-Oct;17(5):521-6 PMID: 4413755
  43. Effects of sulphasalazine (Salazopyrin) on faecal flora in patients with inflammatory bowel disease.
    Gut. 1974 Dec;15(12):960-5 PMID: 4155692
  44. Arthritis associated with intestinal-bypass procedure for morbid obesity. Complement activation and characterization of circulating cryoproteins.
    N Engl J Med. 1976 Jan 15;294(3):121-4 PMID: 1105187
  45. Ankylosing spondylitis: klebsiella and HL-A B27.
    Rheumatol Rehabil. 1977 Aug;16(3):190-6 PMID: 910095
Article Info
Journal
Gut
Abbr.
Gut
ISSN
0017-5749
DOI
10.1136/gut.31.7.777
Published
1990-07-00
Pages
777-80
Language
English
Region
England
NLM ID
2985108R
PMCID
PMC1378534
Subset
IM
Corrections
CommentIn
PMID: 2013436
External Links
PubMed source DOI: 10.1136/gut.31.7.777 PMC Full Text View journal details
Analysis Services
Analysis Services

Contact

No. 2 Wenbo Road, Zhangqiu District, Jinan, Shandong

Qilu Normal University · Genelibs Bioinformatics Lab

750 Shunhua Rd, Jinan

2F, Bldg F, University Science Park

Tel: 0531-88819269

WeChat Official Account

Follow our WeChat subscription account for real-time updates and the latest in medical and biological research.


Business Email

E-mail: product@genelibs.com

Copyright © 2026.Genelibs Jinan Honghui Biotechnology Co., Ltd. 鲁ICP备20007159号-2