https://orcid.org/0000-0003-4631-549X
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Mark Ford, Ilfita Sahbudin, Andrew Filer, Neil Steven, Benjamin A Fisher, High proportion of drug hypersensitivity reactions to sulfasalazine following its use in anti-PD-1-associated inflammatory arthritis, Rheumatology, Volume 57, Issue 12, December 2018, Pages 2244–2246, https://doi.org/10.1093/rheumatology/key234
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Sir, Checkpoint blockade has revolutionized the management of several cancers by targeting the co-inhibitory pathways that down-modulate T cell receptor–mediated T cell activation. However, the resulting enhanced T cell activation also gives rise to immune-related adverse events (IrAEs). Arthritis is an increasingly recognized IrAE following treatment with the licensed antibodies to programmed cell death protein-1 (PD-1) and may persist following discontinuation of anti-PD-1 [1]. Treatment often consists of corticosteroids, with escalation if required to DMARDs. However, uncertainty exists about the possible impact of potent DMARD therapy on the durability of cancer response, with some oncologists reluctant to consider the use of MTX [2].
SSZ combines salicylic acid with the antimicrobial sulfapyridine and has been suggested as one possible therapy for IrAEs [1, 2]. SSZ can cause a drug hypersensitivity reaction that rarely may be systemic and potentially life-threatening [3]. Importantly, such drug hypersensitivity reactions are T cell mediated [4, 5].
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