Strategy in the treatment of ankylosing spondylitis with slow acting anti-rheumatic drugs

Objective To evaluate the efficacy and strategy of the slow acting anti rheumatic drugs such as sulfasalazine(SASP),methotrexate(MTX) and total glycoside of hooks F tripterygium wilfordii(T Ⅱ) in the treatment of ankylosing spondylitis(AS).Methods Eighty nine cases of AS were treated with SASP and/or SASP/MTX/T Ⅱ for 2 years.Data such as morning stiffness,number of join pain and swelling,chest expansion,Schober's test,ESR,CRP and sacroiliac joint radiography/CT scan before and after treatment were collected and analysed.Results In the first year of SASP therapy,the rate of clinical remission,marked improve,effective,and ineffective was 46%,19%,19%,and 16% respectively.In the ineffective cases with SASP treatment for 1 year,MTX was added(or replaced).And after a half year treatment,the rate of clinical remission and marked effective was 81%.The rate of side effect was SASP(20%)MTX(32%)T Ⅱ(50%).Conclusion SASP,MTX and T Ⅱ are safe and effective in the treatment of AS.SASP might be the first choice,MTX the second,and T Ⅱ the last.The treatment should be individualized.For example,SASP might be used in the first year's therapy.And for the serious or refractory cases MTX/T Ⅱ might be added.