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 ) .
Which is the active moiety of sulfasalazine in ankylosing spondylitis? A randomized, controlled study.
OBJECTIVE To compare the efficacy of sulfasalazine ( SSZ ) with its two moieties , 5-aminosalicylic acid ( ASA ) and sulfapyridine ( SP ) , in patients with active ankylosing spondylitis ( AS ) . METHODS A 26-week r and omized , observer-blinded , 2-center , controlled study of treatment with either SSZ , ASA , or SP was conducted in 90 patients with active AS . Patients were evaluated at baseline and at monthly intervals , using several clinical and laboratory measures of disease activity . A global assessment of treatment efficacy was made by both patients and observers at the end of the study period . RESULTS There were no significant changes in any of the parameters of disease activity in the ASA treatment group . Levels of serum IgG , IgA , and IgM fell significantly during treatment with SP , but none of the other changes reached statistical significance . Plasma viscosity and IgG and IgA levels fell significantly during treatment with SSZ , as did nocturnal spinal pain and overall spinal pain . Patients and observers reported a favorable outcome after treatment with SSZ or SP significantly more often than with ASA treatment . CONCLUSION SP appears to be the active moiety in AS , although there was a trend suggesting a better outcome in the SSZ group compared with the SP group , perhaps suggesting the importance of a common sulfonamide structure for efficacy
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 ) .