Second-line treatment in seronegative spondylarthropathies*

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The literature concerning second-line treatment of seronegative spondylarthropathies from 1940 to August 1993 was reviewed. Sulfasalazine appeared to be effective in the treatment of ankylosing spondylitis (AS) and promising in reactive arthritis (ReA) and Reiters' syndrome (RS). Methotrexate and azathioprine were associated with a remarkable improvement in some cases of AS and RS. Methylprednisolone and levamisole were both efficacious in AS, but levamisole was associated with occasional severe side effects. Radiation therapy led to short-term improvement in AS, but was abandoned because of severe long-term side effects. Only sulfasalazine has been studied in sufficient detail to allow definitive conclusions, but methotrexate and azathioprine may be promising drugs.

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  • Cited by (0)

    *

    This study was made possible by a grant from Christiaens B.V. Belgium.

    1

    From the Departments of Rheumatology and Clinical Pharmacology, University Hospital Nijmegen, St. Radboud; and the Department of Rheumatology, St. Maartens Hospital, Nijmengen, the Netherlands.

    2

    Marjonne C.W. Creemers, MD: Trainee in Rheumatology

    3

    Piet L.C.M. van Riel, MD: Associate Professor of Rheumatology

    4

    Marcel J.A.M. Franssen, MD: Rheumatologist

    5

    Levinus B.A. van de Putte, MD: Professor of Rheumatology

    6

    Frank W.J. Gribnau, MD: Professor of Clinical Pharmacology.

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