HbA1c lowering by Sulfasalazine in diabetes due to haemolytic effects: Study
Sulfasalazine is associated with HbA1c lowering by hematological changes consistent with haemolysis and not by glycemia, suggests a study published in the DIABETIC Medicine journal on 25 November 2020.
Sulfasalazine was the first ASA (aminosalicylate) drug effective in inflammatory bowel disease (IBD). The development of 5‐ASA drugs lacking the sulphonamide group eliminated the side effects associated with sulfasalazine. These newer drugs such as mesalazine, balsalazide and olsalazine release the active compound when the drug reaches the distal small bowel area, allowing the benefits of 5‐ASA in IBD without the systemic adverse side effects of sulfasalazine. Several small studies indicate the sulphonamide component of the drug sulfasalazine lowers HbA1c. Based on previous case report/series evidence researchers in the University of Dundee conducted an observational study to assess sulfasalazine association with HBa1C. They also investigated the effect of 5‐ASA drugs on markers of haemolysis, including full blood count–red blood cells (RBC), mean cell haemoglobin (MCH) and haematocrit (HCT).
It was an observational cohort study including Individuals from the Scottish Care Information Diabetes Collaboration (SCI‐Diabetes) with type 2 diabetes and an incident prescription for aminosalicylate drugs (sulfasalazine, n=133; mesalazine, n=103). Baseline and 6‐month HbA1c levels were assessed. To investigate the association with haemolysis, researchers assessed a change in components of full blood count.Baseline characteristics were similar in all patients.
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