The dosage of SSZ (or placebo) were 2.0 g/d or up to 3.0 g/d depending on the efficacy and tolerance. Excludes data and analyses, and appendices, SSZ vs placebo (AS with peripheral arthritis, end point values), SSZ vs placebo (axial form AS, end point values), https://doi.org/10.1002/14651858.CD004800.pub2, Individual access - via Wiley Online Library, data are only available for Cochrane Reviews that contain one or more forest plots; and. No significant difference was found in other parameters. Comparison 1 SSZ vs placebo, Outcome 19 Fingers‐to‐floor test (2nd analysis) (cm). 4. To evaluate the efficacy and toxicity of sulfasalazine for the treatment of ankylosing spondylitis. Subgroup data Studies in the present review could not be grouped according to the characteristics of intervention and participants. You will see translated Review sections in your preferred language. Nothing was special about the intervention. You can find out more about our use of cookies in About Cookies, including instructions on how to turn off cookies if you wish to do so. (2) SSZ management might be beneficial in patients with higher ESR (possibly > 30 mm/hr). Is sulfasalazine effective in ankylosing spondylitis? Current guidelines suggest sulfasalazine (SSZ) treatment as initial therapy for the … In 1990, Ferraz (Ferraz 1990) conducted a meta‐analysis of five randomized controlled trials involving 272 patients and concluded that sulfasalazine significantly relieved pain and morning stiffness, compared with placebo. Data extracted from the included trials were entered independently by JC and CL, using RevMan's double entry facility. After deselection of Schmidt 2002 (no continuous data was available in Kirwan 1993), we found that WMD of chest expansion and WMD of duration morning stiffness (change from baseline) became insignificant, which have been mentioned above. For ESR and morning stiffness outcome, both absolute and relative benefit from SSZ was calculated (Additional table 2). SSZ was no better than placebo for the treatment of the signs and symptoms of uSpA; however, SSZ was more effective than placebo in the subgroup of patients with IBP and no peripheral arthritis. Comparison 1 SSZ vs placebo, Outcome 25 Dactylitis score (0‐3, 0=normal, 3=severe). This is an update of a Cochrane review first published in 2005. But the difference of pooled results was statistically insignificant (Comparison 01.36,37). Only one trial (Krajnc 1990) could match Nissila 1988 in these aspects (duration of disease was not given, baseline ESR was 41 for SSZ and 43 for placebo group, patients with peripheral arthritis took up 66%). Comparison 1 SSZ vs placebo, Outcome 37 Duration of morning stiffness (2nd analysis) (hr). Comparison 1 SSZ vs placebo, Outcome 13 Forced vital volume (change from baseline) (L/min). In Feltelius 1986 and Kirwan 1993, only graphs were presented for most outcomes. Sulfasalazine for ankylosing spondylitis. Two of them (Davis 1989, Krajnc 1990) based the comparisons between the initial and end point results. Peripheral joints/entheses were assessed in several studies (Clegg 1996, Dougados 1986, Kirwan 1993, Nissila 1988, Schmidt 2002). Comparison 2 SSZ vs placebo (AS with peripheral arthritis, end point values), Outcome 7 Degree of joint swelling (0‐66, the higher score the more severe disease). 2020 Jun;7(2):415-423. doi: 10.1007/s40744-020-00208-5. Better health. More people stopped taking sulfasalazine because of the side effects than when taking fake pills. With regard to the side effects of SSZ, the present review showed significantly more withdrawals for side effects and for any reason in SSZ than in placebo group (Comparison 01‐44,46). A systematic review of randomized controlled trials. Comparison 1 SSZ vs placebo, Outcome 1 Spondylitis function index (Score 0‐40, 0‐44, 0=the best, the more the worst). Unblinded trial reports were reviewed independently by two reviewers according to the selection criteria. Treatment recommendations for AS recommend against using sulfasalazine to manage AS, as there is little to no evidence for its effectiveness … We did not analyze them in RevMan because the information of treatment allocation was not given. Unblinded trial reports were reviewed independently by JC and CL according to the selection criteria. Sulfasalazine is a slow-acting anti-rheumatic drug (SAARD) that may be used to treat certain people with ankylosing spondylitis (AS). Comparison 2 SSZ vs placebo (AS with peripheral arthritis, end point values), Outcome 6 Articular index (0‐66, the higher score the more severe disease). Comparison 1 SSZ vs placebo, Outcome 9 Score of daily NSAIDs (change from baseline, usual dosage as 10). Among 469 patients taking SSZ, one was reported to develop a severe skin reaction in Clegg 1996. See this image and copyright information in PMC. Abstract. For EMBASE (Ovid), the search strategy is in Appendix 2. Sensitivity analysis We did not conduct sensitivity analysis for concealment and blind assessment because all trials were rated as A or B. doi: 10.1002/14651858.CD004800.pub2. A similar result was found in the pooled data (Comparison 01.40,41).  |  Jansen FM, Vavricka SR, den Broeder AA, de Jong EM, Hoentjen F, van Dop WA. Comparison 3 SSZ vs placebo (axial form AS, end point values), Outcome 6 Patient assessment of disease severity (VAS‐100mm, 0=very good, 100=very poor). Significant heterogeneity existed among the trials (P =0.02). Comparison 1 SSZ vs placebo, Outcome 33 General well‐being (end point) (VAS‐100mm, 0=very good, 100=very poor). Comparison 3 SSZ vs placebo (axial form AS, end point values), Outcome 5 Fingers‐to‐floor test (cm). Patients were male or female, with or without the impairment of peripheral joints. Curr Rheumatol Rep. 2007 Oct;9(5):349-50. I agree to these terms and conditions Download data, Copyright © 2000 - 2020 by John Wiley & Sons, Inc. All Rights Reserved Review our Privacy Policy, Search for your institution's name below to login via Shibboleth. Comparison 1 SSZ vs placebo, Outcome 30 Spondylitis articular index (2nd analysis) (0‐90, the higher score the more severe disease). For those refractory or intolerant to NSAIDs, the disease modifying antirheumatic drugs (DMARDs) have been used as a second line approach. 2. - Across pivotal clinical trial programs, RINVOQ (15 mg, once daily) demonstrated efficacy across multiple measures of disease activity in psoriatic arthritis (PsA) and ankylosing spondylitis … About cookies 1989 ) presented data of Dougados 1986, most outcomes were given AS medians and 95 % 0.15! 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