LOW-DOSE DESENSITIZATION DOES NOT REDUCE THE TOXICITY OF SULFASALAZINE IN RHEUMATOID-ARTHRITIS

Objective-To examine the proposal that pretreatment low dose desensiti sation may reduce the incidence of toxicity of sulphasalazine in the t reatment of rheumatoid arthritis (RA). Methods-A double blind, placebo controlled trial was performed with 422 patients satisfying the Ameri can College of Rheumatology criteria for RA who required sulphasalazin e treatment because of increased disease activity. Patients received e ither sulphasalazine desensitisation, or placebo, for three weeks befo re commencement of sulphasalazine treatment. The frequency and nature of adverse effects and changes in clinical and laboratory parameters o f disease activity were measured after three and six months. Results-I mprovement in the efficacy of sulphalasazine (measured by clinical and laboratory parameters) was significant and similar in magnitude in bo th groups. There was no significant difference between actively and pl acebo desensitised patients as regards the incidence or profile of adv erse effects (toxicity). Conclusion-Pretreatment low dose desensitisat ion is unhelpful in reducing the toxicity associated with sulphasalazi ne treatment of RA.