title: Comparison of sulfasalazine and placebo in the treatment of psoriatic arthritis. A Department of Veterans Affairs Cooperative Study.
abstract: 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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: VAMC, Salt Lake City, Utah, USA.
authors.forename: D O
authors.initials: DO
authors.lastname: Clegg
authors.forename: D J
authors.initials: DJ
authors.lastname: Reda
authors.forename: E
authors.initials: E
authors.lastname: Mejias
authors.forename: G W
authors.initials: GW
authors.lastname: Cannon
authors.forename: M H
authors.initials: MH
authors.lastname: Weisman
authors.forename: T
authors.initials: T
authors.lastname: Taylor
authors.forename: E
authors.initials: E
authors.lastname: Budiman-Mak
authors.forename: W D
authors.initials: WD
authors.lastname: Blackburn
authors.forename: F B
authors.initials: FB
authors.lastname: Vasey
authors.forename: M L
authors.initials: ML
authors.lastname: Mahowald
authors.forename: J J
authors.initials: JJ
authors.lastname: Cush
authors.forename: H R
authors.initials: HR
authors.lastname: Schumacher
authors.forename: S L
authors.initials: SL
authors.lastname: Silverman
authors.forename: F P
authors.initials: FP
authors.lastname: Alepa
authors.forename: M E
authors.initials: ME
authors.lastname: Luggen
authors.forename: M R
authors.initials: MR
authors.lastname: Cohen
authors.forename: R
authors.initials: R
authors.lastname: Makkena
authors.forename: C M
authors.initials: CM
authors.lastname: Haakenson
authors.forename: R H
authors.initials: RH
authors.lastname: Ward
authors.forename: B J
authors.initials: BJ
authors.lastname: Manaster
authors.forename: R J
authors.initials: RJ
authors.lastname: Anderson
authors.forename: J R
authors.initials: JR
authors.lastname: Ward
authors.forename: W G
authors.initials: WG
authors.lastname: Henderson
mesh_terms: D000328:Adult; D000893:Anti-Inflammatory Agents / Q000009:adverse effects / Q000627:therapeutic use*; D015535:Arthritis, Psoriatic / Q000188:drug therapy*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance; D010919:Placebos / Q000627:therapeutic use*; D012460:Sulfasalazine / Q000009:adverse effects / Q000627:therapeutic use*; D016896:Treatment Outcome; D016312:Treatment Refusal
chemical_list: D000893:Anti-Inflammatory Agents; D010919:Placebos; D012460:Sulfasalazine