2ND-LINE TREATMENT IN SERONEGATIVE SPONDYLARTHROPATHIES

The literature concerning second-line treatment of seronegative spondy lar-thropathies from 1940 to August 1993 was reviewed. Sulfasalazine a ppeared 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 impr ovement in some cases of AS and RS. Methylprednisolone and levamisole were both efficacious in AS, but levamisole was associated with occasi onal severe side effects. Radiation therapy led to short-term improvem ent in AS, but was abandoned because of severe long-term side effects. Only sulfasalazine has been studied in sufficient detail to allow def initive conclusions, but methotrexate and azathioprine may be promisin g drugs. Copyright (C) 1994 by W.B. Saunders Company