Background Sulphasalazine has been suggested as a less effective drug than some of the other disease modifying antirheumatic drugs (DMARDs). It is more suitable for use in milder disease. Sulphasalazine is often the most common first-choice DMARDs because of its good tolerability.
Objectives The aim was to determine the efficacy and tolerability of long-term sulphasalazine treatment of rheumatoid arthritis (RA).
Methods This study examines the response to sulphasalazine (2,0 – 3,0 g daily) over a 2 year period in 40 consecutive patients with severe, active RA. This was defined as seropositiva, erosive RA and persistent activity. Clinical evaluation were performed by the same physician every 3 months and also blood count, erythrocyte sedimentation rate (ESR), serum creatinine, liver blood test and urine were obtained.
Results 40 patients were enrolled in the study. Their mean age at entry to trial was 51,2 ± 11,6 years with a mean duration of disease activity of 4 years. After 3 months of the treatment 21 patients showed no significant clinical improvement. A good clinical response was shown by the improvement of the pain, as well as the reduction of the morning stiffness. Reduction in the acute phase response was shown by improvement in the ESR and C-reactive protein (CRP). Of the 40 patients enrolled in the study, 27 showed highest improvement in swollen joints (p < 0,01), in the duration of morning stiffness (p < 0,01), ESR (p < 0,05), CRP (p < 0,05) after 6 months compared to pretreatment valves. 2 patients were excluded from study because of an leukopenia, and gastrointestine disturbances and in 2 the drug was ineffective.
Conclusion This study confirmed that sulphasalazine is well tolerated and suggests that patients with severe and active RA could achieve good clinical response to sulphasalazine.