Q. Does taking tablet Sulfasalazine impair my Sjogren's syndrome affected wife's Type 1 interferon production?

Answered by
Dr. Sugreev Singh
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on May 22, 2022

Hi doctor,

My wife has had Sjogren's syndrome and related rheumatoid arthritis for about ten years. She has been experiencing a flare for five months now, which has migrated from her knees to her heel and hands. She is nearing 70. She is currently on tablet Sulfasalazine 500 mg, two in the morning and two at night. Occasionally she takes tablet Ibuprofen 800 mg for pain. Studies indicate that tablet Sulfasalazine impairs Type 1 interferon production by plasmacytoid dendritic cells, which can inhibit the immune system from battling the COVID-19 virus. As such, tablet Sulfasalazine has increased the risk of a severe outcome from COVID by 360 percent, or a 3.6 odds ratio. In an international journal, patients with a COVID infection were evaluated, in which 390 (10.5 percent) died. Contrastingly, initial studies by a leading medical center reported rheumatic disease patients were not at increased risk.

So I wonder what my wife's risk is, mainly since she is on tablet Sulfasalazine. Would it be better for her to switch to tablet Methotrexate, as that has been shown to have a lower odds ratio of increased risk?

Please advise me, doctor.

Thank you.



Welcome to

I can understand your concern.

It differs from person to person. Some people have a higher risk, while some do not. But since she has Sjogren's, I would suggest you continue with the same medicine and take precautions for COVID. Even if she stops the medication, there are chances that she may get other infections. So the best way is to continue with the same and take proper precautions. Every person has a different body and immunity. So do not worry about anything.

Thanks and regards.

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