nsaids + sulfasalazine

This is a combination therapy consisting of non-steroidal anti-inflammatory drugs (NSAIDs) and sulfasalazine. NSAIDs are a class of medications that reduce inflammation, pain, and fever by inhibiting cyclooxygenase enzymes (COX-1 and COX-2), thereby decreasing prostaglandin synthesis. Sulfasalazine is a disease-modifying anti-rheumatic drug (DMARD) composed of 5-aminosalicylic acid (5-ASA) linked to sulfapyridine; it acts as an anti-inflammatory agent with immunomodulatory properties, though its precise mechanism in rheumatic diseases is not fully understood. This combination is commonly used in the management of inflammatory conditions such as rheumatoid arthritis when monotherapy does not provide adequate control[1][2][3][6]. The rationale for combining these agents lies in their complementary mechanisms—NSAIDs offer rapid symptomatic relief while sulfasalazine provides long-term disease modification.