[Individualized sulfasalazine treatment of ulcerative colitis and monitoring of patient compliance by determining sulfapyridine serum concentration].

Abstract

Sulphasalazine (SASP) is the drug of choice in the treatment of ulcerative colitis (UC). But there are adverse effects in 20-30% dependent on the serum-level of the resorbed SASP-metabolite sulphapyridine (SP). Relapses during treatment may have their cause in an under-dosage or patient's non-compliance. In 19 patients with UC the possibility of an individualized most effective treatment and the patient's compliance by the simple practicable analysis of SP-serum-level were checked. The results show that it is necessary to dose the SASP in dependence of the genetically determined type of acetylation. The SASP-dosage must be decreased in patients with slow acetylation and vice versa consequently. After rectal SASP-application - in opposite to the oral treatment - significant lower serum levels of SP were analyzed. In 63.1% of the patients we found an insufficient of non-compliance.