Sulfasalazine in the prevention of anterior uveitis associated with ankylosing spondylitis

Purpose To assess the effects of sulfasalazine in preventing recurrences an d reducing the severity of anterior uveitis associated with ankylosing spon dylitis and chronic intestinal inflammation. Methods Twenty-two patients with anterior uveitis associated with ankylosin g spondylitis were studied. Ten patients were randomised to receive oral su lfasalazine (group 1) and 12 patients randomised to no treatment (group 2); all were followed for 3 years. Blood-aqueous barrier permeability was dete rmined by fluorophotometry and bowel biopsies were taken. Results A statistically significant difference was observed between the two groups regarding the number of recurrences of uveitis (p = 0.016). The blo od-aqueous barrier permeability was significantly higher during acute attac ks in group 2 (group 1: 31.3 +/- 26.4 x 10(-4) min(-1) vs group 2: 66.2 +/- 28.5 x 10(-4) min(-1); p = 0.019) but not during the disease-free period. We observed a higher incidence of chronic intestinal inflammation at the en d of the study in group 2 (group 1: 3/8 vs group 2: 7/9, p = 0.153). No rel ation was observed between blood-aqueous barrier permeability and the numbe r of recurrences. The number of patients with severe persistent posterior s ynechiae at the end of the study was higher in group 2 (group 1: 4 patients before and 4 patients at the end; group 2: 4 patients before and 8 patient s at the end; p = 0.65). Conclusion Sulfasalazine may be beneficial in preventing recurrences and re ducing the severity of anterior uveitis associated with ankylosing spondyli tis.