THE USE OF SULFASALAZINE IN PSORIATIC-ARTHRITIS - A CLINIC EXPERIENCE

Objective. To assess the tolerability of sulfasalazine in a clinic set ting and determine its longterm effectiveness with respect to articula r disease and prevention of radiographic progression in patients with psoriatic arthritis (PsA). Methods. Patients who were given sulfasalaz ine during their attendance at the University of Toronto Psoriatic Art hritis Clinic were enrolled in the study. For patients that were able to tolerate sulfasalazine for at least 3 months a matched control was identified who did not receive sulfasalazine. The primary outcome meas ures were the tolerability of sulfasalazine, clinical response of the actively inflamed joints at 6 and 12 months, and the change in radiogr aphic score at 24 months. Results. Thirty-six patients received sulfas alazine. Fourteen of 16 patients discontinued sulfasalazine due to one or more side effects occurring within 3 months of treatment initiatio n. For the remaining 20 patients, a 50% reduction in actively inflamed joint count was noted in 7/20 patients at 6 months and 11/15 patients at 12 months, compared to 7/19 patients in the control group at 6 mon ths and 10/20 patients at 12 months. The mean change in the radiograph ic score at 24 months between the 2 groups was not statistically signi ficant. Conclusion. Sulfasalazine was not well tolerated in patients w ith PsA in our clinic. For those able to tolerate sulfasalazine, there was no evidence of a treatment effect with respect to articular invol vement. In addition, sulfasalazine does not appear to halt radiographi c progression in PsA.