Abstract
We have investigated the influence of sulphasalazine, a second line antirheumatic drug, on the radiological progression of erosions in rheumatoid arthritis over a two year period in 41 patients. Hand radiograph scores deteriorated significantly over this period, but in a group of 31 patients in whom one year films were also available this deterioration was limited to the first year. This slowing of radiological deterioration was not related to 'normalisation' of the erythrocyte sedimentation rate (ESR). Compared with a 'control' group of 10 patients who had refused offers of second line therapy, sulphasalazine treated patients showed less deterioration over the two year period, and this difference was more marked than in previous studies of gold or penicillamine. No significant change was seen in large joint radiographs in sulphasalazine treated patients over two years, but this probably represents the poor sensitivity of the method of assessment. No significant correlation was seen between changes in inflammatory indices and slowing of radiological deterioration in erosion score. Thus sulphasalazine appears to slow the progression of radiological disease of the hands over the second year of treatment in a representative sample of patients who continue to receive treatment for two years.
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- Bax D. E., Amos R. S. Sulphasalazine: a safe, effective agent for prolonged control of rheumatoid arthritis. A comparison with sodium aurothiomalate. Ann Rheum Dis. 1985 Mar;44(3):194–198. doi: 10.1136/ard.44.3.194. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Bird H. A., Dixon J. S., Pickup M. E., Rhind V. M., Lowe J. R., Lee M. R., Wright V. A biochemical assessment of sulphasalazine in rheumatoid arthritis. J Rheumatol. 1982 Jan-Feb;9(1):36–45. [PubMed] [Google Scholar]
- Gofton J. P., O'Brien W. M. Effects of auranofin on the radiological progression of joint erosion in rheumatoid arthritis. J Rheumatol Suppl. 1982 Jul-Aug;8:169–172. [PubMed] [Google Scholar]
- Grindulis K. A., McConkey B. Outcome of attempts to treat rheumatoid arthritis with gold, penicillamine, sulphasalazine, or dapsone. Ann Rheum Dis. 1984 Jun;43(3):398–401. doi: 10.1136/ard.43.3.398. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Larsen A., Dale K., Eek M. Radiographic evaluation of rheumatoid arthritis and related conditions by standard reference films. Acta Radiol Diagn (Stockh) 1977 Jul;18(4):481–491. doi: 10.1177/028418517701800415. [DOI] [PubMed] [Google Scholar]
- McConkey B., Amos R. S., Durham S., Forster P. J., Hubball S., Walsh L. Sulphasalazine in rheumatoid arthritis. Br Med J. 1980 Feb 16;280(6212):442–444. doi: 10.1136/bmj.280.6212.442. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Neumann V. C., Grindulis K. A., Hubball S., McConkey B., Wright V. Comparison between penicillamine and sulphasalazine in rheumatoid arthritis: Leeds-Birmingham trial. Br Med J (Clin Res Ed) 1983 Oct 15;287(6399):1099–1102. doi: 10.1136/bmj.287.6399.1099. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pullar T., Capell H. A. A rheumatological dilemma: is it possible to modify the course of rheumatoid arthritis? Can we answer the question? Ann Rheum Dis. 1985 Feb;44(2):134–140. doi: 10.1136/ard.44.2.134. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pullar T., Hunter J. A., Capell H. A. Does second-line therapy affect the radiological progression of rheumatoid arthritis? Ann Rheum Dis. 1984 Feb;43(1):18–23. doi: 10.1136/ard.43.1.18. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pullar T., Hunter J. A., Capell H. A. Sulphasalazine in rheumatoid arthritis: a double blind comparison of sulphasalazine with placebo and sodium aurothiomalate. Br Med J (Clin Res Ed) 1983 Oct 15;287(6399):1102–1104. doi: 10.1136/bmj.287.6399.1102. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Pullar T., Hunter J. A., Capell H. A. Sulphasalazine in the treatment of rheumatoid arthritis: relationship of dose and serum levels to efficacy. Br J Rheumatol. 1985 Aug;24(3):269–276. doi: 10.1093/rheumatology/24.3.269. [DOI] [PubMed] [Google Scholar]
- Scott D. L., Dawes P. T., Fowler P. D., Grindulis K. A., Shadforth M., Bacon P. A. Anti-rheumatic drugs and joint damage in rheumatoid arthritis. Q J Med. 1985 Jan;54(213):49–59. [PubMed] [Google Scholar]
- Scott D. L., Grindulis K. A., Struthers G. R., Coulton B. L., Popert A. J., Bacon P. A. Progression of radiological changes in rheumatoid arthritis. Ann Rheum Dis. 1984 Feb;43(1):8–17. doi: 10.1136/ard.43.1.8. [DOI] [PMC free article] [PubMed] [Google Scholar]
- Sharp J. T. Radiographic evaluation of the course of articular disease. Clin Rheum Dis. 1983 Dec;9(3):541–557. [PubMed] [Google Scholar]