sulfasalazine / Generic mfg. - LARVOL DELTA

Drug-Induced Pancreatitis Across UC Therapeutics: A Real-World Pharmacovigilance Study (ACG 2026) - " FAERS was queried for reports of pancreatitis associated with UC treatments including immunomodulators (azathioprine, mercaptopurine, methotrexate, tacrolimus), 5-aminosalicylates (mesalamine, balsalazide, olsalazine, sulfasalazine), anti-TNF agents (adalimumab, infliximab, golimumab, certolizumab pegol), integrin inhibitors (vedolizumab, natalizumab), IL-12/23 inhibitors (ustekinumab, risankizumab, guselkumab), JAK inhibitors (tofacitinib, upadacitinib), and S1P modulators (ozanimod, etrasimod). 83,046 reports with 612 pancreatitis cases were analyzed. Significantly elevated risk was observed with azathioprine (ROR 4.38, 95% CI 3.56-5.38), mesalamine (ROR 2.32, 95% CI 1.87-2.89), and infliximab (ROR 1.47, 95% CI 1.21-1.80; all p< 0.0001). Reduced risk was identified with adalimumab (ROR 0.60, 95% CI 0.49-0.74), vedolizumab (ROR 0.69, 95% CI 0.51-0.93), and ustekinumab (ROR 0.13, 95% CI 0.02-0.94)."

Adverse events • Clinical • Real-world • Real-world evidence • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Pancreatitis • Ulcerative Colitis • IL12A • ROR1

A Rare Case of Collagenous Gastroduodenitis (ACG 2026) - "No established treatment guidelines exist, though reported therapies include corticosteroids, proton pump inhibitors, sucralfate, and sulfasalazine. This case highlights the importance of considering collagenous gastroduodenitis in patients with unexplained upper gastrointestinal symptoms and nodular mucosa on endoscopy, even without collagenous colitis, and emphasizes careful medication review. Figure: A.Nodular stomach mucosa on endoscopy B.Nodular duodenum mucosa on endoscopy C. and D. Stomach mucosa with thickened subepithelial collagen band (light pink on the H&E images, blue on the trichrome images) E. and F. Duodenal mucosa with marked villous atrophy and a thickened subepithelial collagen band"

Clinical • Cardiovascular • Celiac Disease • Dyslipidemia • Dyspepsia • Gastroenterology • Gastrointestinal Disorder • Hypertension • Immunology • Inflammation • Mucositis • Obstructive Sleep Apnea • Rare Diseases • Respiratory Diseases • Sleep Disorder

Herpes Zoster Infection as an Adverse Reaction to Treatments for Ulcerative Colitis: A Review of Reports to the FDA Adverse Events Reporting System (FAERS) (ACG 2026) - "Reports of ADRs of all FDA approved UC therapies including mesalamine, sulfasalazine, balsalazide, olsalazine, methotrexate, azathioprine, 6-mercaptopurine, infliximab, adalimumab, certolizumab, golimumab, vedolizumab, ustekinumab, mirikizumab, risankizumab, guselkumab, ozanimod, etrasimod, tofacitinib, and upadacitinib along with combination infliximab with methotrexate, infliximab with azathioprine, adalimumab with azathioprine, and golimumab with azathioprine were reviewed. Table 1 displays the total FAERS reports of ADRs and reported HZ infection in patients treated for UC. The JAK inhibitor tofacitinib showed increased risk of HZ with 58 total reports (ROR 2.79). In addition, methotrexate (ROR 1.83), azathioprine (ROR 1.74), 6-mercaptopurine (ROR 2.4), infliximab (ROR 2.49), and combination therapies of infliximab with methotrexate (ROR 2.61) and infliximab with azathioprine (ROR 2.91) demonstrated increased risk."

Adverse events • Review • Gastroenterology • Gastrointestinal Disorder • Herpes Zoster • Immunology • Infectious Disease • Inflammatory Bowel Disease • Ulcerative Colitis • Varicella Zoster • ROR1

Melena Unmasking Undifferentiated Carcinoma of the Pancreas With Osteoclast-Like Giant Cells (ACG 2026) - "Case Description/ A 77-year-old male, with ulcerative colitis (well controlled on sulfasalazine), mild aortic stenosis, and recently diagnosed Type 1 diabetes mellitus presented with melena for 1 week and subacute generalized weakness and lightheadedness. He recently started aspirin, but denied NSAIDs, anticoagulants, steroids, smoking, and alcohol use...He was started on FOLFIRINOX with pembrolizumab and completed palliative radiation...Figure B: CT abdomen and pelvis with 4.4 cm cystic and solid pancreatic head mass with upstream pancreatic atrophy and dilatation of main pancreatic duct. Figure C: Pathology with poorly differentiated carcinoma with osteoclast-like giant cells."

Diabetes • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Metabolic Disorders • Oncology • Pancreatic Cancer • Pancreatic Ductal Adenocarcinoma • Solid Tumor • Type 1 Diabetes Mellitus • Ulcerative Colitis • VIM

Anti-TNF-Induced Lupus Myopericarditis in a Pregnant Patient With Ulcerative Colitis: A Case Report (ACG 2026) - "Case Description/ A 29-year-old woman at 27 weeks gestation with longstanding UC in endoscopic remission (Mayo score 0) on infliximab (IFX) 5 mg/kg every 8 weeks and sulfasalazine presented two days after a scheduled infusion with acute pleuritic chest pain, exertional dyspnea, and palpitations...The patient was treated with intravenous methylprednisolone 60 mg daily and colchicine 0.5 mg twice daily, with subsequent transition to oral prednisolone on a structured taper...Figure: Transthoracic echocardiography revealed a large circumferential pericardial effusion (maximal posterior dimension 2.4 cm) without echocardiographic evidence of tamponade physiology, accompanied by an associated pleural effusion and a dilated inferior vena cava measuring 2.2 cm. Left ventricular systolic function was preserved with an estimated ejection fraction exceeding 55%, and no regional wall motion abnormalities were identified."

Case report • Clinical • Cardiovascular • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Arthritis • Inflammatory Bowel Disease • Lupus • Musculoskeletal Diseases • Pulmonary Disease • Pulmonary Embolism • Respiratory Diseases • Ulcerative Colitis

Rapid Growth of a Giant Inflammatory Polyp Mimicking Rectal Malignancy in Well-Controlled Crohn's Colitis: A Diagnostic and Therapeutic Challenge (ACG 2026) - "Case Description/ A 73-year-old woman with longstanding ileocolonic Crohn's disease, status post ileocolonic resection, decompensated cirrhosis with esophageal varices, IBS-D, diabetes, and hypertension is in clinical and endoscopic remission on sulfasalazine for 8 years...The patient was started on vedolizumab for its favorable safety profile, with sustained tolerance and improvement in diarrhea previously attributed to IBS-D...Figure: Polyp containing foci of hyperplastic glands and surface erosion with granulation tissue (A, H&E, 40x). Higher magnification of expanded lamina propria with mixed inflammatory cells; no dysplasia or carcinoma is identified (B, H&E, 100x)."

Cardiovascular • Colorectal Cancer • Crohn's disease • Diabetes • Fibrosis • Gastroenterology • Gastrointestinal Disorder • Hepatology • Hypertension • Immunology • Inflammatory Bowel Disease • Metabolic Disorders • Oncology • Rectal Cancer • Solid Tumor

Advanced Therapy Utilization Among Patients With Inflammatory Bowel Disease in Latin America: A Systematic Review and Meta-Analysis (ACG 2026) - "Conventional therapies remained widely used, including mesalamine 60.8% (95% CI, 47.53%â73.47%), steroids 37.5% (95% CI, 22.59%â50.38%), azathioprine 30.39% (95% CI, 20.65%â41.09%), sulfasalazine 21.9% (95% CI, 1.56%â54.97%), and methotrexate 1.41% (95% CI, 0.46%â2.82%). Forty studies reported biologic utilization among patients with IBD. The pooled prevalence of biologic use was 23.2% (95% CI, 16.5%â30.6%; I²=99.5%). Figure1."

Metastases • Retrospective data • Review • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease

A Silent Disease Speaks: Symptomatic Gastric Sarcoidosis (ACG 2026) - "His current medications include azathioprine and sulfasalazine...He started on pantoprazole 40mg twice a day and prednisone 30mg daily with plans for steroid taper...Alternatively, immunosuppressive agents such as methotrexate or azathioprine can be used. Surgical interventions are reserved in cases with obstruction, perforation, or bleeding."

Dyspepsia • Gastroesophageal Reflux Disease • Gastrointestinal Disorder • Immunology • Infectious Disease • Inflammatory Arthritis • Sarcoidosis • CRP

Not All Sacroiliitis Is Crohn's: Myeloid Sarcoma Presenting as Progressive Back Pain in a Young Woman With Crohn's Disease (ACG 2026) - "Case Description/ A 32-year-old woman with Crohnâs disease, on sulfasalazine and infliximab with prior azathioprine use, presented with 2 months of lower back pain associated with bilateral lower extremity paresthesia. AI was used to edit the abstract. Figure: Figure 1: Cutaneous involvement of hematological malignancy Figure: Figure 2: MRI T2 weighted image showing thecal sac compression"

Clinical • Acute Myelogenous Leukemia • Back Pain • Crohn's disease • Gastroenterology • Hematological Malignancies • Immunology • Inflammatory Arthritis • Inflammatory Bowel Disease • Leukemia • Lymphoma • Musculoskeletal Diseases • Musculoskeletal Pain • Pain • Sarcoma • Solid Tumor

Orange You Glad It Was Negative? Sulfasalazine and Invalid Urine Drug Screens in a Patient With Ulcerative Colitis (ACG 2026) - "Given this test was reproducible with two invalid urine samples followed by a negative urine sample after holding sulfasalazine is reassuring that sulfasalazine was the culprit. If receiving an invalid UDS and on sulfasalazine, one should consider holding sulfasalazine."

Clinical • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammatory Bowel Disease • Ulcerative Colitis • Ulcerative proctitis

Age-Dependent Effects of GLP-1 Receptor Agonists on Clinical Outcomes in Inflammatory Bowel Disease: A Propensity-Matched Real-World Study (ACG 2026) - "Within each, GLP-1 RA users were propensity score matched 1:1 to non-users on gender; race/ethnicity (Hispanic, White, African-American, Asian, other); type 2 diabetes; Crohnâs disease; ulcerative colitis; hyperlipidemia; hypertension; ischemic heart disease; CKD; MASLD; obesity; insulin; SGLT2 inhibitors; prior hospitalization; and baseline IBD therapy including aminosalicylates (mesalamine, sulfasalazine), thiopurines/immunomodulators (azathioprine, mercaptopurine, methotrexate), anti-TNF agents (infliximab, adalimumab, certolizumab pegol, golimumab), vedolizumab, IL-12/23 and IL-23 inhibitors (ustekinumab, risankizumab), and JAK inhibitors (tofacitinib, upadacitinib). Primary cohorts (vs non-users): 1,958 (18â45), 5,412 (45â65), 2,928 ( >65). GLP-1 RA use was associated with lower hospitalization, ED visits, and IV corticosteroid use across all cohorts (Table 1, Figure 1). The 45â65 cohort had the most comprehensive benefit: reduced all-cause..."

Clinical • Clinical data • Real-world • Real-world evidence • Acute Kidney Injury • Cardiovascular • Chronic Kidney Disease • Coronary Artery Disease • Crohn's disease • Diabetes • Dyslipidemia • Gastroenterology • Gastrointestinal Disorder • Genetic Disorders • Heart Failure • Hypertension • Immunology • Inflammation • Inflammatory Bowel Disease • Metabolic Disorders • Metabolic Dysfunction-Associated Steatotic Liver Disease • Nephrology • Obesity • Pancreatitis • Renal Disease • Type 2 Diabetes Mellitus • Ulcerative Colitis • IL12A • IL23A

Immunosuppressant Management in Rheumatology Patients Undergoing Elective Total Shoulder Arthroplasty (clinicaltrials.gov) - P2 | N=80 | Recruiting | Sponsor: NYU Langone Health | Not yet recruiting ➔ Recruiting | Trial completion date: Sep 2027 ➔ Jan 2028 | Initiation date: Sep 2025 ➔ Dec 2025 | Trial primary completion date: Sep 2027 ➔ Jan 2028

Enrollment open • Trial completion date • Trial initiation date • Trial primary completion date • Orthopedics • Psoriatic Arthritis • Rheumatology

Disease-modifying antirheumatic drugs (DMARDs) for rheumatoid arthritis after failure of biologic or targeted synthetic therapy: a systematic review and network meta-analysis. (PubMed, Cochrane Database Syst Rev) - "We found high-certainty evidence that nine therapies and moderate-certainty evidence that two therapies provide a clinically important benefit in improving disease activity compared to placebo for people with rheumatoid arthritis after failure of b/ts DMARD therapy. There was significant uncertainty surrounding treatment-related harms, with the evidence having been downgraded for serious or extremely serious imprecision. Pair-wise comparisons showed no significant differences among therapies, although the certainty of evidence was low. The lack of clarity regarding safety and comparative efficacy suggests that treatment decisions should be guided by individual patient characteristics and preferences."

Clinical • Journal • Retrospective data • Review • Fatigue • Immunology • Infectious Disease • Inflammatory Arthritis • Oncology • Pain • Rheumatoid Arthritis • Rheumatology • IL6

Rapid growth of a giant inflammatory polyp mimicking rectal malignancy in well-controlled Crohn's colitis: a diagnostic and therapeutic challenge. (PubMed, Proc (Bayl Univ Med Cent)) - "A 73-year-old woman with longstanding ileocolonic Crohn's disease that had been in endoscopic and histologic remission on sulfasalazine for 8 years developed a rapidly growing, fungating, ulcerated pedunculated rectal lesion, endoscopically indistinguishable from rectal carcinoma, within 1 year of a completely normal surveillance colonoscopy...She was subsequently escalated to vedolizumab after individualized consideration of her advanced liver disease and the agent's gut-selective mechanism, with sustained clinical improvement. This case highlights that quiescent IBD does not preclude alarming endoscopic findings, that inflammatory polyps can develop rapidly and mimic malignancy, and that even patients with apparent remission may have residual histologic disease activity. Pathologic evaluation remains indispensable, and such lesions should prompt reassessment of therapeutic adequacy."

Journal • Colorectal Cancer • Crohn's disease • Gastroenterology • Gastrointestinal Disorder • Hepatology • Immunology • Inflammatory Bowel Disease • Oncology • Rectal Cancer • Solid Tumor

Clinical and laboratory manifestations and treatment of children with TNFRSF1A gene variants. (PubMed, World J Clin Pediatr) - "Variants in the TNFRSF1A gene may cause a wide range of clinical symptoms, including eye and intestinal lesions that are not typical of sJIA. All patients with fever and unusual sJIA symptoms should have molecular genetic testing for TNFRSF1A variants to confirm or exclude AID early. Early diagnosis enables timely therapy and prevents complications. Tocilizumab (39.3%), canakinumab (33.3%), and TNF inhibitors (21.2%) achieved remission in children with TNFRSF1A variants. Some patients required multiple bDMARD switches to achieve remission, highlighting the complexity of treatment decisions in this group."

Journal • Amyloidosis • CNS Disorders • Gastrointestinal Disorder • Idiopathic Arthritis • Immunology • Infectious Disease • Inflammation • Oncology • Otorhinolaryngology • Pain • Pediatrics • Rheumatology • Ventriculomegaly • TNFRSF1A

The Impact of Common Medications on Male Fertility: An Updated Systematic Review. (PubMed, Andrology) - "In this updated review, evidence-based recommendations for clinical management and for possible fertility preservation or contraception in men of reproductive age receiving common acute or chronic medical treatment are provided, with the goal of making these data more readily available to medical staff."

Journal • Review • Infertility

Advances in ferroptosis mechanisms and therapeutic potential in head and neck squamous cell carcinoma. (PubMed, Front Cell Dev Biol) - "Cisplatin-based chemoradiotherapy remains the standard of care, yet widespread chemoresistance limits head and neck squamous cell carcinoma (HNSCC) clinical efficacy...Pharmacologic inducers such as erastin, RSL3, sulfasalazine, dihydroartemisinin, and HDAC inhibitors effectively trigger ferroptosis and suppress tumor growth, both in vitro and in vivo, while combination strategies with photodynamic therapy or mutant TP53 modulation further enhance antitumor effects. Emerging predictive models incorporating ferroptosis-related genes, miRNAs, and lncRNAs enable prognostic stratification and may guide individualized therapy. This review highlights ferroptosis as a therapeutic vulnerability in HNSCC, offering new avenues to overcome chemoresistance and improve patient outcomes."

Journal • Review • Head and Neck Cancer • Oncology • Solid Tumor • Squamous Cell Carcinoma • Squamous Cell Carcinoma of Head and Neck • GPX4 • SLC7A11 • TP53

Effectiveness of Sulfasalazine Therapy Following Mesalazine Treatment Failure in Children with Ulcerative Colitis. (PubMed, Pediatr Gastroenterol Hepatol Nutr) - "Relapse-free survival did not differ among mesalazine, sulfasalazine, and azathioprine treatments (p=0.182). Switching from mesalazine to sulfasalazine may be a viable therapeutic option for carefully selected children with mild to moderate UC, even after mesalazine treatment failure."

Journal • Gastroenterology • Gastrointestinal Disorder • Immunology • Inflammation • Inflammatory Bowel Disease • Pediatrics • Ulcerative Colitis

Therapeutics Beyond Delivery: Repurposed Drugs and Biologic Pathways. (PubMed, Curr Hypertens Rep) - "Metformin has demonstrated a trend towards prolongation of pregnancy in a randomized controlled trial, with larger trials ongoing. Proton pump inhibitors and sulfasalazine show compelling preclinical efficacy, though neither has yet translated to clinical benefit, possibly reflecting inadequate drug exposure in vivo. Novel biologic approaches, including sFlt-1-targeting siRNA, complement inhibition with eculizumab, and placenta-tropic lipid nanoparticle delivery systems, represent promising emerging strategies. Advancing molecular classification of pre-eclampsia is essential to identifying targetable pathways and selecting patients most likely to benefit from specific interventions. Improved pharmacokinetic evaluation in pregnancy, earlier identification of at-risk women using circulating biomarkers, and regulatory frameworks supportive of obstetric research will be critical to translating promising candidates into effective therapies."

Journal • Review • Gynecology • Obstetrics

Sulfasalazine-induced fixed drug eruption with a pellagra-like distribution: an uncommon clinical mimic (EADV 2026) - No abstract available

Clinical

Drug rash with eosinophilia and systemic symptoms (DRESS) induced by sulfasalazine: severe presentation in a patient with hyper-IgD syndrome (EADV 2026) - No abstract available

Clinical • Eosinophilia

WHEN TREATMENT BECOMES TOXIC: A CASE OF DRUG-INDUCED PNEUMONITIS ASSOCIATED WITH SULFASALAZINE (CHEST 2026) - No abstract available

Clinical • Inflammation • Pneumonia

The Effect of Nicorandil on Rheumatoid Arthritis Patients (clinicaltrials.gov) - P2/3 | N=70 | Recruiting | Sponsor: Ain Shams University | Not yet recruiting ➔ Recruiting

Enrollment open • Immunology • Inflammatory Arthritis • Rheumatoid Arthritis • Rheumatology

Rheumatoid Arthritis in Adults: A Review. (PubMed, JAMA) - "The European Alliance of Associations for Rheumatology recommends starting treatment with methotrexate, 7.5 mg to 10 mg orally weekly, increasing to 20 mg to 25 mg weekly within 4 to 8 weeks, and considering addition of short-term glucocorticoids (eg, prednisone, 5-7.5 mg/d), tapered and discontinued within 3 months, or 1 intramuscular injection of 80 mg to 160 mg depot methylprednisolone. For patients with contraindications to methotrexate, sulfasalazine (2-4 g/d) or leflunomide (20 mg/d) is recommended...First-line initial therapy is methotrexate, with consideration of glucocorticoids as additive therapy. For patients who do not achieve remission with this initial treatment, adding biological DMARDs or JAK inhibitors increases overall remission or low disease activity rates to 80%."

Journal • Cardiovascular • Immunology • Inflammatory Arthritis • Oncology • Pulmonary Disease • Respiratory Diseases • Rheumatoid Arthritis • Rheumatology • Vasculitis • CRP

Study of ECC4703 With Sulfasalazine and Pitavastatin (clinicaltrials.gov) - P1 | N=40 | Recruiting | Sponsor: Eccogene | Not yet recruiting ➔ Recruiting

Enrollment open • Dyslipidemia • Hepatology • Metabolic Dysfunction-Associated Steatotic Liver Disease