SULFASALAZINE THERAPY FOR PSORIATIC-ARTHRITIS - A DOUBLE-BLIND, PLACEBO-CONTROLLED TRIAL

Objective, Psoriatic arthritis (PsA) is often poorly responsive to 2nd line antirheumatic drug therapy, Sulfasalazine has recently gained wi de acceptance in the treatment of rheumatoid arthritis, and beneficial effects have also been noted in ankylosing spondylitis and reactive a rthritis. We report a double blind placebo controlled study of sulfasa lazine in PsA. Methods, Twenty-four patients with active PsA were rand omized to receive either sulfasalazine (3 g/day) (n = 10) or placebo ( n = 14) for 8 weeks, in a double blind manner, followed by an 8 week o pen label crossover phase for nonresponding placebo patients. Results, Compared with placebo controls, sulfasalazine treated patients were s ignificantly improved at Weeks 4 and 8 with respect to physician (p < 0.01) and patient (p < 0.05) global assessments, Duration of morning s tiffness was significantly decreased at Week 8 (p < 0.01). Clinical va riables of disease activity returned to baseline after a 4 week drug w ashout period in 5 evaluable patients, Six patients in the placebo gro up crossed over to an 8 week open label phase and demonstrated signifi cant improvements in joint scores, 50 ft walking time, and global pati ent assessment. Sulfasalazine treated patients also showed significant improvements in cutaneous involvement. Conclusion, Sulfasalazine was effective in PsA, with efficacy observed as early as the 4th week of t reatment. Longterm studies are needed to determine whether such therap y can modify disease outcome.