There is not enough evidence to support any benefit of sulfasalazine in reducing pain , disease activity , radiographic progression , or improving physical function and spinal mobility in the treatment of AS .
A statistically significant benefit in reducing the erythrocyte sedimentation rate and easing spinal stiffness was mentioned in the previous version .
More withdrawals because of side effects occurred with sulfasalazine .
BACKGROUND Ankylosing spondylitis ( AS ) is a chronic inflammatory disease of unknown cause and affects mainly the spine , but can also affect other joints .
Disease progression may result in loss of mobility and function .
Sulfasalazine is a disease-modifying antirheumatic drug used in the treatment of AS .
However , its efficacy remains unclear .
This is an up date of a Cochrane review first published in 2005 .
OBJECTIVES To evaluate the benefits and harms of sulfasalazine for the treatment of ankylosing spondylitis ( AS ) .
[Treatment of ankylosing spondylitis with salazosulfapyridine. A controlled double-blind study in 60 patients].
The efficacy of salazosulfapyridine ( SI ) has been recently reported in the course of peripheral arthritis in ankylosing spondylarthritis ( SPA ) , but is action on the axial forms of the disease was not known . We have therefore conducted a therapeutic trial in 60 patients suffering from SPA , without peripheral involvement clinical sign evoking an enterocolopathy . This double-blind study compared the activity of SI at a dose of 2 g/day with a placebo , for 6 months . Thirteen patients had to discontinue the treatment : 6 in the placebo group ( inefficacy : 3 cases , anemia : 1 case , epigastric pain : 1 case , rash : 1 case ) and 7 cases in the SI group ( inefficacy : 2 cases , nauseous : 3 cases , abdominal pain : 1 case , moderate elevation of transaminases : 1 case ) . These 13 patients were kept for the global analysis and considered as therapeutic failures . The treatment was considered effective in 15 out of 30 patients of group SI and in 30 patients on placebo ( p less than 0.02 ) . In addition , in group SI , a statistically significant decrease of the daily dose of non-steroid anti-inflammatory drugs  was observed ( -6.5 + /- 7.2 versus -2.4 + /- 6.4 in the placebo group , p less than 0.05 ) ; also was observed a decrease of the functional index ( -5.9 + /- 6.6 versus -1.9 + /- 5.7 in the group placebo , p less than 0.05 ) and of the serum level of immunoglobulin G ( -1.8 + /- 3.6 g/l versus + 0.8 + /- 2.9 in the placebo group , p less than 0.025 ) . ( ABSTRACT TRUNCATED AT 250 WORDS
There is not enough evidence to support any benefit of sulfasalazine in reducing pain , disease activity , radiographic progression , or improving physical function and spinal mobility in the treatment of AS .
A statistically significant benefit in reducing the erythrocyte sedimentation rate and easing spinal stiffness was mentioned in the previous version .
More withdrawals because of side effects occurred with sulfasalazine .
BACKGROUND Ankylosing spondylitis ( AS ) is a chronic inflammatory disease of unknown cause and affects mainly the spine , but can also affect other joints .
Disease progression may result in loss of mobility and function .
Sulfasalazine is a disease-modifying antirheumatic drug used in the treatment of AS .
However , its efficacy remains unclear .
This is an up date of a Cochrane review first published in 2005 .
OBJECTIVES To evaluate the benefits and harms of sulfasalazine for the treatment of ankylosing spondylitis ( AS ) .