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 ) .
Comparison of sulfasalazine and placebo for the treatment of axial and peripheral articular manifestations of the seronegative spondylarthropathies: a Department of Veterans Affairs cooperative study.
OBJECTIVE To determine if the peripheral articular manifestations of the seronegative spondylarthropathies ( SNSA ) respond differently than the axial manifestations to treatment with sulfasalazine ( SSZ ) . METHODS This is a re analysis of a previously reported series of r and omized , double-blind , placebo-controlled , multicenter trials comparing the effects of SSZ , 2,000 mg/day , and placebo on the axial and peripheral articular manifestations of ankylosing spondylitis ( AS ) , psoriatic arthritis ( PsA ) , and reactive arthritis ( ReA ; Reiter 's syndrome ) . Patients were classified as treatment responders on the basis of meeting predefined improvement criteria in 4 outcome measures : namely , patient and physician global assessment s in all patients , morning stiffness and back pain in patients with axial manifestations , and joint pain/tenderness scores and joint swelling scores in patients with peripheral articular manifestations . RESULTS Six hundred nineteen SNSA patients ( 264 AS , 221 PsA , and 134 ReA ) were studied . One hundred eighty-seven of these patients had only axial manifestations of their disease , while 432 patients had peripheral articular manifestations . Of the patients with axial disease , 40.2 % of the SSZ group and 43.3 % of the placebo group met the predefined response criteria ( P = 0.67 ) . Of the peripheral articular group , 59.0 % of the SSZ-treated patients and 42.7 % of the placebo-treated patients showed a response ( P = 0.0007 ) . CONCLUSION In a large group of affected individuals , the response of SNSA patients to SSZ appears to be related to the articular manifestations of their disease . These data demonstrate that the axial and peripheral articular manifestations of SNSA respond differently to treatment with SSZ . In SNSA patients with persistently active peripheral arthritis , SSZ is safe , well tolerated , and effective
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 ) .