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 ) .
Sulfasalazine in the treatment of spondylarthropathy. A randomized, multicenter, double-blind, placebo-controlled study.
OBJECTIVE To assess the efficacy and tolerability of sulfasalazine ( SSZ ) in the treatment of spondylarthropathy . METHODS We conducted a 6-month r and omized , placebo-controlled , double-blind , multicenter study of patients with spondylarthropathy whose disease had remained active despite treatment with nonsteroidal antiinflammatory drugs . Patients were treated with SSZ ( 3 gm/day ) or placebo . The primary efficacy variables were the physician 's and patient 's overall assessment s , pain , and morning stiffness . End points were analyzed in the intent-to-treat and completer patient population s ; the time course of effect was analyzed in the completer patient population . RESULTS Of the 351 patients enrolled , 263 ( 75 % ) completed the 6-month treatment period . The withdrawal rates were 35 ( 20 % ) and 53 ( 30 % ) in the placebo and SSZ groups , respectively . In the intent-to-treat analysis of end point efficacy , the between-treatment difference reached statistical significance only for 1 of the 4 primary outcome variables , the patient 's overall assessment of disease activity , for which 60 % of the patients taking SSZ improved by at least 1 point on a 5-point scale , in contrast to 44 % of the patients taking placebo .  Laboratory markers of inflammation also showed statistically significant change in favor of SSZ . In subgroup analysis , the most impressive effects were seen in patients with psoriatic arthritis , both for the 4 primary efficacy variables and for secondary efficacy variables such as the number of inflamed joints . Adverse events were more frequent in the SSZ group than the placebo group , but all were transient or reversible after cessation of treatment . CONCLUSION The results of this study show that SSZ had greater efficacy than placebo in the treatment of active spondylarthropathy , notably in patients with psoriatic arthritis
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 ) .