Clinical Rheumatology

, Volume 10, Issue 1, pp 43–48 | Cite as

Sulphasalazine in ankylosing spondylitis. A radiological, clinical and laboratory assessment

  • H. G. Taylor
  • E. J. Beswick
  • P. T. Dawes


In a 12-month double-blind placebo-controlled trial, the effect of sulphasalazine was studied in 40 patients with ankylosing spondylitis. The treatment group showed significant improvement in pain, stiffness, sleep disturbance (p<0.05), finger/floor distance, erythrocyte sedimentation rate, C-reactive protein, orosomucoid and IgA levels (p<0.01). There was improvement in sleep disturbance (p<0.05), finger/floor distance and erythrocyte sedimentation rate (p<0.01) in the placebo group. Sulphasalazine did not retard radiological progression as measured either by plain X-ray or computerised tomographic scans. Multiple analysis of variance did not show a significant difference in disease activity indicators between the 2 groups.

Key words

Sulphasalazine Ankylosing Spondylitis Disease Modifying Antirheumatic Drug 


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  1. 1.
    Feltelius, N., Hallgren, R. Sulphasalazine in ankylosing spondylitis. Ann Rheum Dis 1986, 45, 396–399.PubMedGoogle Scholar
  2. 2.
    Dougados, M., Boumier, P., Amor, B. Sulphasalazine in ankylosing spondylitis: a double-blind controlled study in 60 patients. Br Med J 1986, 293, 911–914.Google Scholar
  3. 3.
    Nissila, M., Lehtinen, K., Leirisalo-Repo, M., Luukhainen, R., Mutru, O., Yli-Kerttula, U. Sulphasalazine in the treatment of ankylosing spondylitis. Arthritis Rheum 1988, 31, 1111–1116.PubMedGoogle Scholar
  4. 4.
    Hepburn, B. What is a disease modifying antirheumatic drug? J Rheumatol 1988, 15 (Supp 16), 40–42.Google Scholar
  5. 5.
    Hyde, S. Physiotherapy in Rheumatology. Oxford, Blackwell Scientific Publications, 1980, 121–122.Google Scholar
  6. 6.
    McConkey, B., Amos, R.S., Butler, E.P., Crockson, R.A., Crockson, A.P., Walsh, L. Salazopyrin in rheumatoid arthritis. Agents Actions 1978, 8, 438–441.PubMedGoogle Scholar
  7. 7.
    Wardle, T., Beswick, E.J., Dawes, P.T. Scoring radiological damage in ankylosing spondylitis (AS) — analysis of the X-ray score and clinical/laboratory variables. Br J Rheumatol 1988, 27 (Supp 1), 547.Google Scholar
  8. 8.
    Pullar, T., Hunter, J.A., Capell, H.A. Sulphasalazine in rheumatoid arthritis: a double-blind comparison of sulphasalazine with placebo and sodium aurothiomalate. Br Med J 1983, 287, 1102–1104.Google Scholar
  9. 9.
    Pinals, R.S., Kaplan, S.B., Lawson, J.G., Hepburn, B. Sulphasalazine in rheumatoid arthritis. A double-blind, placebo-controlled trial. Arthritis Rheum 1986, 29, 1427–34.PubMedGoogle Scholar
  10. 10.
    Editorial. Assessing disease activity in ankylosing spondylitis. Lancet 1987, i, 1072.Google Scholar
  11. 11.
    Nashel, D.J., Petrone, D.L., Ulmer, C.C., Sliwinski, A.J., C-reactive protein: a marker for disease activity in ankylosing spondylitis and Reiter's Syndrome. J Rheumatol 1986, 13, 2, 364–367.PubMedGoogle Scholar
  12. 12.
    Cowling, P., Ebringer, R., Cawdell, D., Ishii, M., Ebringer, A. C-reactive protein, ESR and klebsiella in ankylosing spondylitis. Ann Rheum Dis 1980, 39, 45–49.PubMedGoogle Scholar
  13. 13.
    Sheeham, N.J., Slavin, B.M., Donovan, M.P., Mount, J.N., Nathews, J.A. Lack of correlation between clinical disease activity and erythrocyte sedimentation rate, acute phase proteins or protease inhibitors in ankylosing spondylitis. Br J Rheumatol 1986, 25, 171–174.PubMedGoogle Scholar
  14. 14.
    Laurent, M.R., Panayi, G.S. Acute-phase proteins and serum immunoglobulins in ankylosing spondylitis. Ann Rheum Dis 1983, 42, 524–528.PubMedGoogle Scholar
  15. 15.
    Cowling, P., Ebringer, R., Ebringer, A. Association of inflammation with raised serum IgA in ankylosing spondylitis. Ann Rheum Dis 1980, 39, 545–549.PubMedGoogle Scholar
  16. 16.
    Franssen, M.J.A.M., van de Putte, L.B.A., Gribnau, F.W.J. IgA serum levels and disease activity in ankylosing spondylitis: a prospective study. Ann Rheum Dis 1985, 44, 766–771.PubMedGoogle Scholar
  17. 17.
    Sanders, K.M., Hertzman, A., Escobar, M.R., Littman, B.H. Correlation of immunoglobulin and C-reactive protein levels in ankylosing spondylitis and rheumatoid arthritis. Ann Rheum Dis 1987, 46, 273–276.PubMedGoogle Scholar
  18. 18.
    Mielants, H., Veys, E.M., Joos, R. Sulphasalazine (Salazopyrin) in the treatment of enterogenic reactive synovitis and ankylosing spondylitis with peripheral arthritis. Clin Rheumatol 1986, 5, 80–83.PubMedGoogle Scholar
  19. 19.
    McGuigan, L.E., Prendergast, J.K., Geczy, A.F., Edmonds, J.P., Bashir, H.V. Significance of non-pathogenic cross reactive bowel flora in patients with ankylosing spondylitis. Ann Rheum Dis 1986, 45, 566–571.PubMedGoogle Scholar
  20. 20.
    Ebringer, R.W., Cawdell, D.R., Cowling, P., Ebringer, A. Sequential studies in ankylosing spondylitis. Association of klebsiella pneumoniae with active disease. Ann Rheum Dis 1978, 37, 146–151.PubMedGoogle Scholar
  21. 21.
    Pease, P.E., Balmer, S.E., Tallack, J.E., et al. Further observations upon HLA-B27, Yersinia enterocolitica and ankylosing spondylitis. Ann Rheum Dis 1986, 45, 526–528.Google Scholar
  22. 22.
    Trull, A.K., Ebringer, A., Panayi, G., Ebringer, R., James, D.C.O. HLA-B27 and the immune response to enterobacterial antigens in ankylosing spondylitis. Clin Exp Immunol 1984, 551, 74–80.Google Scholar
  23. 23.
    Andreason, J.J., Andersen, L.P., Hartgen, S.H. In vitro susceptibility of diarrhoea producing gram negative enteric bacteria to sulfasalazine, 5 aminosalicylic acid, sulfapyridine and four quinolones. APMIS 1988, 96, 568–570.PubMedGoogle Scholar
  24. 24.
    Boersma, J.W. Retardation of ossification of the lumbar vertebral column in ankylosing spondylitis by means of phenylbutazone. Scand J Rheumatol 1976, 5, 60–64.PubMedGoogle Scholar

Copyright information

© Acta Medica Belgica 1991

Authors and Affiliations

  • H. G. Taylor
    • 1
  • E. J. Beswick
    • 1
  • P. T. Dawes
    • 1
  1. 1.Staffordshire Rheumatology CentreHaywood HospitalBurslemUK

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