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Author Spotlight: Evaluating Traditional Chinese Therapy for Ankylosing Spondylitis in Mice
Published on: October 27, 2023
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Sulfasalazine for ankylosing spondylitis.
Junmin Chen1, Shaopeng Lin, Chao Liu
1Department of Hematology and Rheumatology, The First Affiliated Hospital of Fujian Medical University, #20 Chazhong Road, Fuzhou, Fujian Province, China, 350005.
The Cochrane Database of Systematic Reviews
|November 28, 2014
Summary
Sulfasalazine shows no clear benefit for ankylosing spondylitis (AS) pain or function, with increased withdrawals due to side effects. More research is needed to confirm its efficacy and safety in AS treatment.
Area of Science:
- Rheumatology
- Clinical Pharmacology
Background:
- Ankylosing spondylitis (AS) is a chronic inflammatory disease impacting the spine and joints, potentially leading to mobility loss.
- Sulfasalazine, a disease-modifying antirheumatic drug (DMARD), is used for AS, but its effectiveness is uncertain.
- This review is an update of a 2005 Cochrane review examining sulfasalazine's role in AS management.
Purpose of the Study:
- To evaluate the benefits and harms of sulfasalazine in treating ankylosing spondylitis (AS).
Main Methods:
- Searched for randomized and quasi-randomized trials using multiple databases (CENTRAL, MEDLINE, EMBASE, CINAHL) and clinical trial registries.
- Included 11 studies with 895 participants comparing sulfasalazine to placebo, assessing risk of bias and extracting data.
- Analyzed continuous data using mean difference (MD) or standardized mean difference (SMD) and dichotomous data using risk ratio (RR).
Main Results:
- No studies assessed key outcomes like BASDAI, BASFI, BASMI, or radiographic progression.
- Sulfasalazine did not show a statistically significant reduction in back pain compared to placebo (MD -2.96).
- A significantly higher rate of withdrawals due to adverse effects was observed with sulfasalazine (RR 1.50), with one serious adverse reaction reported.
Conclusions:
- Insufficient evidence supports sulfasalazine's benefit in reducing pain, disease activity, or improving function in AS.
- While previous findings suggested minor benefits in erythrocyte sedimentation rate and spinal stiffness, these were not clinically meaningful.
- Increased side effect-related withdrawals necessitate further high-quality studies to clarify sulfasalazine's role in AS treatment.
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