Second-line treatment in seronegative spondylarthropathies.
The literature concerning second-line treatment of seronegative spondylarethropathies from 1940 to August 1993 was reviewed. Sulfasalazine appeared 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 improvement in some cases of AS and RS. Methylprednisolone and levamisole were both efficacious in AS, but levamisole was associated with occasional severe side effects. Radiation therapy led to short-term improvement in AS, but was abandoned because of severe long-term side effects. Only sulfasalazine has been studied in sufficient detail to allow definitive conclusions, but methotrexate and azathioprine may be promising drugs.
Department of Rheumatology, University Hospital Nijmegen, St. Radboud, The Netherlands.
M C
MC
Creemers
P L
PL
van Riel
M J
MJ
Franssen
L B
LB
van de Putte
F W
FW
Gribnau
D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use*; D001168:Arthritis / Q000188:drug therapy* / Q000276:immunology / Q000532:radiotherapy; D002986:Clinical Trials as Topic; D006801:Humans; D000091402:Prohibitins; D012698:Serologic Tests; D013166:Spondylitis / Q000188:drug therapy* / Q000276:immunology / Q000532:radiotherapy
D018501:Antirheumatic Agents; C000717331:PHB2 protein, human; D000091402:Prohibitins