Sulfasalazine

THURSDAY, Sept. 11, 2025 -- In a global consensus statement published online Aug. 28 in Clinical Gastroenterology and Hepatology, recommendations are presented for managing pregnancy in women with inflammatory bowel disease (IBD). Uma Mahadevan, M.D., from the University of California in San Francisco, and colleagues reviewed the current data to determine best practices for management of pregnancy in IBD. The topics were divided into 10 categories; 34 recommendations and 35 consensus statements were issued. The authors recommend counseling women with IBD that active disease increases the risk for infertility compared with inactive disease (strong recommendation). Although women with IBD may have decreased fertility compared with those without IBD, women with IBD may have comparable effectiveness with assisted reproductive technology as measured by live birth (conditional recommendations). Women with IBD are encouraged to undergo preconception counseling (strong recommendation). Maintenance 5-aminosalicylate therapy is recommended to be continued among women with IBD who are pregnant or attempting conception (strong recommendation); maintenance sulfasalazine therapy is suggested and corticosteroid therapy is suggested when clinically necessary with appropriate monitoring (conditional recommendations); however, maintenance methotrexate should be discontinued prior to conception (strong recommendation). Breastfeeding is recommended as it is not associated with an increased risk for disease exacerbation (strong recommendation). "The goal of our study and consortium has been to provide hope, comfort, and the same high-level care to current and future mothers with IBD," Mahadevan said in a statement. "The consensus recommendations are the first truly global effort to improve treatment and outcomes for women with IBD and their children." Several authors disclosed ties to the pharmaceutical industry. Abstract/Full Text

TUESDAY, Sept. 9, 2025 — A common rheumatoid arthritis drug appears to also lower blood pressure , potentially reducing patients’ risk of heart disease, a new study says. Methotrexate significantly lowered blood pressure compared to another arthritis drug called sulfasalazine , researchers reported recently in the Annals of Medicine . “We found that methotrexate lowered systolic blood pressure by an average of 7.4 mm/Hg compared with people taking sulfasalazine,” said lead researcher Arduino Mangoni , a strategic professor of clinical pharmacology with Flinders University in Australia. “This kind of reduction is considered meaningful because even a small drop in blood pressure can lower the risk of serious heart problems like heart attacks and strokes,” he said in a news release. Rheumatoid arthritis occurs in about 1 in 100 people, researchers said in background notes. It’s an autoimmune disorder that occurs when the immune system attacks a person’s joints, causing pain and swelling. For the new study, researchers randomly assigned 62 newly diagnosed RA patients to receive regular injections of either methotrexate or sulfasalazine. After six months, people receiving methotrexate had significantly lower systolic blood pressure. Systolic is the pressure in the blood vessels during a heart beat. It’s the top number in a blood pressure reading. Researchers found that this benefit did not appear linked to either improvements in a person’s arthritis symptoms or the stiffness of their arteries. That means the drug might be helping the heart in other ways, like calming inflammation or improving blood vessel health. “We’ve known for a while that methotrexate helps with inflammation, but now we’re seeing that it may also help lower blood pressure, which is a major risk factor for heart disease,” Arduino said. “This could be a big step forward in how we care for people with rheumatoid arthritis.” Results also showed that certain genetic traits made some people more likely to experience a drop in blood pressure on methotrexate. “In short, if someone has specific gene variants, methotrexate might add a heart health benefit to its usual role in treating rheumatoid arthritis by the positive effect on blood pressure,” Arduino said. However, senior researcher Sara Tommasi noted that further study is needed to confirm these findings and figure out exactly why methotrexate lowers blood pressure in some. “The results suggest that this well-known arthritis drug could also play a role in protecting heart health, especially in people who are at higher risk due to inflammation,” Tommasi, a medical scientist at the University of Flinders, said in a news release. Sources Flinders University, news release, Sept. 3, 2025