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Sulfasalazine for Peripheral AS #283499 08/19/19 01:56 PM
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kc119 Offline OP
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So rheumy believes I have a spawn from AS, peripheral or undifferential AS, possible reactive arthritis... the label hasn't been written in stone yet. He started me on anti-infllammatories which didn't touch my pain, now Sulfasalazine, has anyone had success with this and how long to know if it will work?

Re: Sulfasalazine for Peripheral AS [Re: kc119] #283501 08/19/19 06:38 PM
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A bit surprising that anti inflammatory drugs did not provide any relief. What are you taking?

I had some success with sulfasalazine for lateral rib pain and SI/dorsal spine pain a couple of years ago. After 6 months of sulfasalazine I was well enough to be able to go most days pain free without meloxicam (this was the anti inflammatory drug that worked best for me). This was combined with Zoloft and Welbutrin for depression. I stopped sulfasalazine when I started Humira; unfortunately I had to stop Humira and get back on sulfasalazine and it never worked as well as the first time i took it, perhaps due to taking it without the anti depressant medication.

So yes I had success with it and for timing you need to give it at least a few months, it takes a while to build up a therapeutic effect.

Re: Sulfasalazine for Peripheral AS [Re: aks] #283502 08/19/19 07:14 PM
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kc119 Offline OP
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Hey! I tried indomethacin, celebrex, and another one can't remember at the moment for nsaid, all of them made me sorta spacey with brain fog with not much pain relief so i stopped after about 4 days. Muscle relaxer didn't work either.

Re: Sulfasalazine for Peripheral AS [Re: kc119] #283506 08/19/19 08:58 PM
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4 days is not a long enough trial to determine if an NSAID will work for you. It may take as long as two weeks to build up to a therapeutic blood level of the drug, and you may not see any benefits before then.

Re: Sulfasalazine for Peripheral AS [Re: kc119] #283519 08/21/19 06:12 AM
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I have been on sulfasalazine for 15 yrs. it is a God send for my Feet. Mainly my heels. I have always had such incredible pain in that area. And it helps so much. Also, it has always helped to keep my Crohns somewhat in check. It’s a known fact that it helps with inflammation of the gut. It takes about 3-6 weeks to really take full force, at least in my case, but has been worth it. I take 1500 mg a day. During my earlier bad yrs when I was in active flare, 8 yrs ago, I was taking 3000 mg a day. I am pretty much done fusing now and deal with just my residual AS damage and osteoporosis and osteoarthritis along with numerous other ailments. Stick with the sulfasalazine. Best wishes for you. You’ll be in my prayers.


Life Is What You Make It
Diag. 1984 Ankylosing Spondylitis./ Shoulder surgery 1/13. Spinal Stenosis, Adrenal Insufficiency, Used Enbrel 8 yrs. Tried Remicade, Simponi, Humira. Stopped all TNF's due to Neuro Side effects. Taking Sulfasalazine, Prednisone,Tramadol, Tizanadine, Voltarin Gel. Stopped working 8/4/12 Currently on Long term disability and SSDI
Re: Sulfasalazine for Peripheral AS [Re: kc119] #283520 08/21/19 08:18 PM
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A couple things I want to add - a couple of rheumatologists have mentioned to me that sulfasalazine dose should consider your body weight. If you are a bigger person you might need more than the standard 2 gr/day. Also, you want the pills with enteric coating to avoid stomach upsets.

Re: Sulfasalazine for Peripheral AS [Re: kc119] #283535 08/24/19 03:29 PM
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Sulfasalazine can help. For me, combined with a low starch diet, it allowed me to manage my SpA well. However, as simply a medication without other interventions, it had no value. It is not currently recommended by the rheumatology associate for SpA.

It seems to be related to the the anti-microbial action in the digestive tract.


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Re: Sulfasalazine for Peripheral AS [Re: kc119] #283554 08/30/19 12:51 PM
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Sulfasalazine 3mg a day worked for me, I was finally able to fix that bursitis in the left retro calcaneus. Seems Sulfasalazine has some anti biotic that helps to regulate the microbiome. cant take it a the moment due to pregnancy planning.
anti inflammatory works for me only as pain relief and usually when I switch to it i get uveitis some time later and I have to start prednisone

now I am experimenting with enhanced bioviabilty curcumin, to kill uveitis flares (too early to say)...and some Omega 3 but taken with sesame oil to kill the omega 6 effect

for me if not for the uveitis i would be able to cope with 1 COX 2 inhibitor per week, because I do pilates/yoga 6 times per week + 4 sessions of 30 min swimming, also started surfing classes (isn't that insane!). the fuk up in my case is that persistent iritis which cannot go on without meds at this moment. and when it begins, noninflammatory is not enough!

that why I will try this stuff from Monday, ordered from Italy, but there is also US shop.

https://clinicaltrials.gov/ct2/show/NCT03584724

my rheumy, says for AS I wont get Humira because my CRP is <15 (protocol), I have like 6 or smth at the moment. I could probably be able to increase it to 15 with some techniques, but I guess there is a reason for everything.

Last edited by achala; 08/30/19 02:14 PM.

diagnosed with AS April 2018, starting with cervical pain/stiffness; Aug 2018 enthesitis/bursitis left Achilles
diagnosed with AAU Nov 2017 (7 flares so far)
Eosinophilic Gastritis
Sulfasalazine 3g 08.2018-05.2019 (worked for AAU & peripheral)
Supplements:C/D, omega 3/Probiotic/ Mediterranean NSD/curcumin
swimming/yoga/pilates
Predonisone in case of another AAU flare
Re: Sulfasalazine for Peripheral AS [Re: kc119] #283565 09/06/19 05:45 AM
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Originally Posted by kc119
Hey! I tried indomethacin, celebrex, and another one can't remember at the moment for nsaid, all of them made me sorta spacey with brain fog with not much pain relief so i stopped after about 4 days. Muscle relaxer didn't work either.


Symptoms of brain fog can either come from your body clearing chemical waste (if a drug is toxic to you) or from a leaky BBB. I would recommend trying to take a dose of GABA and see if you also get an effect. If you do, this would be a confirmation that your BBB is leaky as, normally, GABA is not able to cross the BBB. It is actually synthesized in the brain but cannot get in from the outside.

Re: Sulfasalazine for Peripheral AS [Re: achala] #283566 09/06/19 05:48 AM
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Originally Posted by achala
Sulfasalazine 3mg a day worked for me, I was finally able to fix that bursitis in the left retro calcaneus. Seems Sulfasalazine has some anti biotic that helps to regulate the microbiome. cant take it a the moment due to pregnancy planning.
anti inflammatory works for me only as pain relief and usually when I switch to it i get uveitis some time later and I have to start prednisone

now I am experimenting with enhanced bioviabilty curcumin, to kill uveitis flares (too early to say)...and some Omega 3 but taken with sesame oil to kill the omega 6 effect

for me if not for the uveitis i would be able to cope with 1 COX 2 inhibitor per week, because I do pilates/yoga 6 times per week + 4 sessions of 30 min swimming, also started surfing classes (isn't that insane!). the fuk up in my case is that persistent iritis which cannot go on without meds at this moment. and when it begins, noninflammatory is not enough!

that why I will try this stuff from Monday, ordered from Italy, but there is also US shop.

https://clinicaltrials.gov/ct2/show/NCT03584724

my rheumy, says for AS I wont get Humira because my CRP is <15 (protocol), I have like 6 or smth at the moment. I could probably be able to increase it to 15 with some techniques, but I guess there is a reason for everything.


Generally, eye symptoms are related to antigens and other markers in the body that are in response to bacterial agents. It would make sense that NSAIDs might cause this to happen if you have intestinal permeability issues. You could look at my post about the link between AS, AAU, ReA, and other SpA's and the way I am looking at treatment here: Link

Might be interesting to you =)

Also, Norflo Oro is a curcumin supplement that is delivered via a phospholipid encapsulation. This is related to the newer generation of curcumin delivery technologies. I have recently heavily researched this and am using CurQFen, which is essentially the same thing but bound to Fenugreek fibers. I've tried CurcumRx, CurcuWin, and Theracurmin as well. CurQFen causes little to no stomach upset for me. CurcumRx put me in crisis mode and I felt like I wanted to die! I even passed out because I could not remain awake. It is just super powerful and harsh (it contains ALL of the terpenes, sesquiterpenoids...EVERYTHING). I would recommend trying to get your hands on CurQFen or Theracurmin HP if you want to check out the viability of these products for your eyes. I can tell you that it helps with my AS pain tremendously and my eyes (I don't have AAU but episcleritis) did seem clearer most of the time.

Hope this helps!

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