Objectives To assess the efficacy of methotrexate and sulphasalazine in patients with active AS.

Methods 30 patients with AS satisfying the New York criteria for AS were randomly divided into two groups. One group (21 patients) received 1.5–2 g/d SS for 6 months and the other (9 patients) – methotrexate 7.5–10 mg/week. 25 clinical and laboratory criteria were assessed. Positive changes (over 20% from baseline) in 20 and more variables were considered as excellent effect; 14–19, good; 6–13, moderate; 1–5, no response.

Results 21 patients completed the study (17 on SS and 4 on MT). In SS group there were 2 patients with excellent effect, 6 with good effect, 7 with moderate one and only 2 had no response. 3 patients treated with methotrexate had moderate effect and 1 patient had good one. 5 patients dropped out of the trial due to adverse reactions:3 in MT group (liver enzymes elevations, low back pain, myalgia/ossalgia) and 2 in SS group (allergic rash, taste disorder). We observed several transient side effects. 2 patients from SS group complained of dizziness, that resolved spontaneously. One of them had anaemia, for which he experienced benefit with folic acid. One patient had concentration disorder.

Conclusion These data suggest that SS is an effective treatment for AS and it is necessary to continue this comparative study.