- People who took placebo rated their pain to be 50 on a scale of 0 to 100 after 3 to 36 months. Even though ankylosing spondylitis is a type of arthritis, it only affects about 1 in 1000 people. Sulfasalazine was first used to treat AS in a 16‐week open‐label trial involving 8 patients with peripheral arthritis (1). We conducted a review of the effect of sulfasalazine for people with ankylosing spondylitis. Sulfasalazine was started at a dosage of 500 mg daily, which, appropriately, was escalated slowly so that the full dosage of 3 gm daily was not reached until week 6. Eighty‐five patients with active ankylosing spondylitis (AS) were randomized to receive either sulfasalazine (≤3 gm/day, mean 2.5) or placebo for 26 weeks. Ankylosing spondylitis (AS) is a lifelong condition that has no cure. To evaluate the benefits and harms of sulfasalazine for the treatment of ankylosing spondylitis (AS). Clinical efficacy and safety of etanercept versus sulfasalazine in patients with ankylosing spondylitis: a randomized, double-blind trial. It occurs most frequently in white males 20 to 40 years old, although it can occur in children, too. - People who took sulfasalazine rated their pain to be 47 on a scale of 0 to 100 after 3 to 36 months. As you've probably guessed by now, I have ankylosing spondylitis. Henan University of Traditional Chinese Medicine researchers investigated the benefits of drugs, acupuncture, and herbal medicine for the treatment of ankylosing spondylitis. Sulfasalazine has shown to be effective for the peripheral joint involvement in ankylosing spondylitis and other SpA, but not for axial sypmtoms (14, 15). Sulfasalazine for the treatment of ankylosing spondylitis: Relic or niche medication? Also, your doctor might ask you to take a deep breath to see if you have difficulty expanding your chest. Our findings are summarised below. Evidence Central is an integrated web and mobile solution that helps clinicians quickly answer etiology, diagnosis, treatment, and prognosis questions using the latest evidence-based research. and you may need to create a new Wiley Online Library account. In the Prospective Study of Outcomes in Ankylosing Spondylitis (PSOAS), a large observational study of patients enrolled at 5 rheumatology centers in the US, 30% of 888 patients reported ever having been treated with sulfasalazine (Ward M: unpublished observations). Dr. Ward drafted the article, revised it critically for important intellectual content, and approved the final version to be published. Braun J, van der Horst-Bruinsma IE, Huang F, Burgos-Vargas R, Vlahos B, Koenig AS, Freundlich B. A statistically significant benefit in reducing the erythrocyte sedimentation rate and easing spinal stiffness was mentioned in the previous version. What is ankylosing spondylitis and what is sulfasalazine? After searching for all relevant studies up to November 2013, we found 11 studies involving 895 people. We restructured outcome measures for this update based on recommendations from the editorial group. - 9 out of 100 people taking fake pills withdrew due to adverse events. Use the link below to share a full-text version of this article with your friends and colleagues. A serious adverse reaction was reported in one patient taking sulfasalazine (Peto odds ratio 7.50, 95% CI 0.15 to 378.16). Please check your email for instructions on resetting your password. The first … Working off-campus? Currently available conventional treatments are palliative at best, and often fail to control symptoms in the long term. Some evidence suggests that sulfasalazine may reduce recurrences of uveitis among patients with AS, but there is no evidence that it prevents or slows the progression of spinal fusion or structural damage (6). However, not all subjects had peripheral joint involvement, and the primary end point assessed axial symptoms, not peripheral joint manifestations. Learn more. However, the efficacy of sulfasalazine may be greater in patients with early AS and in those with peripheral arthritis. Sulfasalazine is a slow-acting anti-rheumatic drug (SAARD) that may be used to treat certain people with ankylosing spondylitis (AS). Side effects, warnings and precautions, drug interactions, and safety during pregnancy should be reviewed prior to taking this medication. E-mail address: wardm1@mail.nih.gov. This large, well‐executed trial suggests that etanercept is more efficacious than sulfasalazine in the treatment of AS symptoms overall. However, its efficacy remains unclear. Ankylosing spondylitis (AS) is a chronic inflammatory disease of unknown cause, characterized by sacroiliitis and spondylitis. This is also reflected in the cur-rent ASAS/European League Against Rheumatism recommendations for the management of ankylosing spondylitis Braun J(1), Pavelka K, Ramos-Remus C, Dimic A, Vlahos B, Freundlich B, Koenig AS. He or she might try to reproduce your pain by pressing on specific portions of your pelvis or by moving your legs into a particular position. The former question examines peripheral arthritis as the outcome, while the latter question examines peripheral arthritis as a predictor of response. Post Views: 219. The primary goals of treatment of ankylosing spondylitis (AS) are to reduce axial musculoskeletal pain and stiffness, control enthesitis, improve fatigue, and preserve flexibility and mobility. These findings are in contrast to those in studies showing the established efficacy and rapid adoption of TNF inhibitors to treat active AS. Two reviewers independently selected the studies and assessed the methodological quality. We do not know whether unblinding to sulfasalazine also occurred, due to its common gastrointestinal and neurologic side effects. - 13 out of 100 people taking sulfasalazine withdrew due to adverse events. Treatment of ankylosing spondylitis by inhibition of tumor necrosis factor α, Presence of peripheral arthritis and male sex predicting continuation of anti–tumor necrosis factor therapy in ankylosing spondylitis: an observational prospective cohort study from the South Swedish Arthritis Treatment Group Register, Clinical efficacy and safety of etanercept versus sulfasalazine in patients with ankylosing spondylitis: a randomized, double‐blind trial, Ankylosing spondylitis and the spondyloarthropathies. Although NSAIDs are commonly the first line of medications used to treat ankylosing spondylitis and related diseases, sometimes they aren’t enough to control the symptoms. Major outcomes included: pain, Bath ankylosing spondylitis disease activity index (BASDAI), Bath ankylosing spondylitis function index (BASFI), Bath ankylosing spondylitis metrology index (BASMI), radiographic progression, total number of withdrawals due to adverse events, and serious adverse events. the axial manifestations of ankylosing spondylitis. Sulfasalazine is a disease-modifying antirheumatic drug used in the treatment of AS. June 17, 2011 — A new study has confirmed etanercept efficacy in early, active ankylosing spondylitis (AS) but did not quite knock sulfasalazine out of contention. Pain and stiffness occur and limit movement in the back and in other joints that are affected. Cochrane Database of Systematic Reviews 2014, Issue 11. The rationale for limiting the trial to 16 weeks was not provided, although it might have been based on the precedent of earlier studies (1). 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