Re: need help interpreting labs for IBD

September 28, 2005

>

http://www.breakingtheviciouscycle.info/knowledge_base/kb/azulfidine_and_

asacol.htm

>

> and

> http://www.healingcrow.com/ELF/ELF51.html

Thanks. I don't have internet access but DH will send me the text later.

Something to look into since I want him off the prednisone soon.

Take care, Fay

September 28, 2005

Fay,

Here's a print out of the links I sent:

Elaine writes:

Just got through reading a recent article from GUT, 2001, Vol. 248,

which again reaffirms what has been obvious to me: that the older drug,

salphasalzine (Azulfidine) which was replaced when the patent ran out

with the supposedly better drug, Asacol, is less effective than the

orginal drug.

Here is an excerpt:

During the period 1938-1954, the only drug available for treatment of UC

was sulphasalazine (SASP). Nanna Svartz used SASP, which is composed of

a sulphonamide-sulphapyridine and a salicylate-5-aminosalicylic acid (5-

ASA). Because of its anti-bacterial activity, it was postulated that the

onset of UC might have some linkage with bacteria.4 Though we know today

that 5-ASA is the active part of SASP,5 a recent meta-analysis showed a

trend towards a superior efficacy of the parent compound over 5-ASA

derivates in the prevention of UC relapses.

Elaine writes:

I know that the Asacol seems to be without efficacy for 98% of the

people to whom I speak. But the azulfidine does not breed yeast and it

is one of the older and more effective drugs. I was told this story by

the president of a drug company: In spite of the fact that azulfidine

was the tried and tested help for almost 50 years, the patent began

running out. (By the way, the azulfidine fools microbes, bacteria and

yeast, into picking up a " counterfeit " molecule with which they make

their own folic acid and which they need to multiply) The generic drug

companies started producing azulfidine since the patent ran out and the

big companies now had a competitive product, just as good, but much

cheaper. So the big companies started a big hype about the azulfidine:

that they had finally found out what the active component was (this was

a lie, they knew for years it minimized the growth of microbes) and that

this component would be put in a new breakthrough drug called 5-amino

salicylic acid. You know it as Asacol and a few others.The terrible

thing about this was that the active component in Azulfidine was not so

much 5-amino salicylic acid as it was the sulfated form of para-amino-

benzoic-acid which was designed to fool bacteria into picking it up and

trying to make their own folic acid out of it (they cannot use preformed

folic acid as we do). So every doctor connected with the powers-that-be

went about lecturing about this new discovery. I attended a lecture

while doing research in London, Ontario at St. ph Hospital and Dr.

W. C. Watkins gave the hype on the new drug. I had learned otherwise in

microbiology and I raised my hand to say 'BUT WE DO KNOW WHICH COMPONENT

IN AZULFIDINE IS MOST EFFECTIVE' and he waved me down. So that is the

story. I would call my regular GI doctor and you need not go into a

whole spiel but I would tell him another doctor took you off the

Azulfidine and you don't know what to do at this point. This is a

perfect example of why someone who does not know everything should take

it easy. You need help. I would stay with the diet. Don't aggravate your

doctor more by trying to explain this diet; he said you could eat

anythingthat agreed with you but get the colitis under control right

away.

__________________________________

Question: What was the more effective drug, Asacol or Azulfidine?

Elaine writes:

The Asacol which contains only an aspirinlike antiinflammatory is of

little effectiveness in 98% of all people (l00's) I've talked to. The

azulfidine, altho it has some 5-amino-salicyclic in it also contains a

bacteria fighter called a counterfeit of para-amino-benzoic acid which

the bacteria are fooled into picking up and then not being able to make

babies as a result. For years, it was believed that the sulfa compound

in the para-amino-benzoic acid caused sensitivities; now the newer

research is saying it probably is the 5-amino-salicylic acid. I do wish

there were some ways for you folks to read this so I do not have to

write it every day.

September 28, 2005

> Hi Debora. DH sent me the text to the links you mentioned. I'm including

> a few lines because of a major question I have: Does she mean that the

> " supposedly better ...Asacol " is less effective than the original drug

> sulphasalazine (Azulfidine)? I think so - only thing that makes sense but

> want to be sure.

Yes, Asacol is less effective then sulphasalazine.

> I'll try to ask the GI but I know he'll tell me that because of where the

> CD is, and the studies on early intervention use, Imuran is still

> important.

> Also, where does Pentasa fit in - is it more like Asacol or the original

> drugs?

Yes, Pentasa is like Asacol; a 5 ASA. Sulphasalazine has a lot more

tendencity to cause allergic reaction, or other side effects, so 5ASA's

were developed for people who couldn't tolerate the sulpha. However, as

Elaine writes, the sulpha had anti-microbrial properties which was the

main part of its efficacy. The 5ASA's are antiinflammatory, but do not

have antimicrobrial action. The Imuran is going to suppress the immune

system, as you know, and sulfasalazine or 5ASAs are usually taken along

with that, not instead of. However, like you, I always was extremely

weary of that supression, and am currently on sulfasalazine alone. But

I have very limited inflammation, and my doctor is in support of that (I

was on Remicade last year, but after having surgery, didn't need it

anymore.) I don't think switching will assuage his suggestions, but it

may just provide more daily maintenance, and hopefully SCD will work so

that the immune suppression is not needed.

September 28, 2005