Treatment of spondyloarthropathy with 5-aminosalicylic acid (mesalazine): an open trial.
OBJECTIVE
Ankylosing spondylitis (AS) and spondyloarthropathy (SpA) are inflammatory diseases of unknown etiology. Various exogenous and endogenous (inherited) factors play a role in their development. Sulfasalazine (SSZ) is generally accepted as a disease modifying drug in the treatment of AS and SpA. Which part of SSZ, 5-acetylsalicylic acid (5-ASA, mesalazine) or sulfapyridine (SP), is the effective moiety is unknown. As the bowel, colon, and the ileum play an important role in the development of AS and SpA, it may be possible that 5-ASA is the effective moiety, with a similar mode of action as in the treatment of inflammatory bowel disease. To determine the efficacy of 5-ASA an open pilot study was done in 2 groups of patients with SpA.


METHODS
Twenty patients with SpA, who were taking SSZ, were switched to 5-ASA (Pentasa), and 19 patients with active SpA were treated with 5-ASA without previous administration of SSZ.


RESULTS
In the first group, 17 (85%) patients responded with respect to the physician global clinical assessment compared to the previous SSZ treatment period; whereas in the second patient group a statistically significant improvement was obtained in erythrocyte sedimentation rate.


CONCLUSIONS
The results support our hypothesis that 5-ASA might be the active moiety of SSZ in the treatment of SpA.
Dekker-Saeys
B J
BJ
Department of Rheumatology, Jan van Breemen Institute, and University of Amsterdam, The Netherlands.
Dijkmans
B A
BA
Tytgat
G N
GN
D000328:Adult; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use*; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D001799:Blood Sedimentation / Q000187:drug effects; D005260:Female; D006801:Humans; D008297:Male; D019804:Mesalamine / Q000627:therapeutic use*; D008875:Middle Aged; D010865:Pilot Projects; D019233:Retreatment; D013166:Spondylitis / Q000097:blood / Q000188:drug therapy* / Q000503:physiopathology; D012460:Sulfasalazine / Q000009:adverse effects / Q000627:therapeutic use; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D012460:Sulfasalazine; D019804:Mesalamine