Comparison of sulfasalazine and placebo in the treatment of psoriatic arthritis

D. O. Clegg, D. J. Reda, E. Mejias, G. W. Cannon, M. H. Weisman, T. Taylor, E. Budiman-Mak, W. D. Blackburn, F. B. Vasey, M. L. Mahowald, J. J. Cush, H. R. Schumacher, S. L. Silverman, F. P. Alepa, M. E. Luggen, M. R. Cohen, R. Makkena, C. M. Haakenson, R. H. Ward, B. J. ManasterR. J. Anderson, J. R. Ward, W. G. Henderson

Research output: Contribution to journalReview articlepeer-review

441 Scopus citations


Objective. To determine whether sulfasalazine (SSZ) at a dosage of 2,000 mg/day is effective for the treatment of active psoriatic arthritis (PsA) resistant to nonsteroidal antiinflammatory drug therapy. Methods. Two hundred twenty-one patients with PsA were recruited from 15 clinics, randomized (double-blind) to SSZ or placebo treatment, and followed up for 36 weeks. Treatment response was based on joint pain/ tenderness and swelling scores and physician and patient global assessments. Results. Longitudinal analysis revealed a trend favoring SSZ treatment (P = 0.13). At the end of treatment, response rates were 57.8% for SSZ compared with 44.6% for placebo (P = 0.05). The Westergren erythrocyte sedimentation rate declined more in the PsA patients taking SSZ than in those taking placebo (P < 0.0001). Adverse reactions were fewer than expected and were mainly due to nonspecific gastrointestinal complaints, including dyspepsia, nausea, vomiting, and diarrhea. Conclusion. SSZ at a dosage of 2,000 mg/day is well tolerated and may be more effective than placebo in the treatment of patients with PsA.

Original languageEnglish (US)
Pages (from-to)2013-2020
Number of pages8
JournalArthritis and rheumatism
Issue number12
StatePublished - Dec 1996


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