Combination therapies in spondyloarthropathies

Abstract

Objectives: To compare the efficacy and tolerability of single-agent sulfasalazine (SSZ) with combination therapies composed of SSZ and methotrexate (MTX) and SSZ, MTX and hydroxychloroquine (HCQ) in active spondyloarthropathy (SpA) patients with peripheral arthritis.

Methods: One hundred and fifty SpA patients with peripheral arthritis (male/ female: 92/58) who were treated in our clinic between 1994 and 1998 were enrolled in this trial. Patients treated with SSZ alone (1-3 gr/day) were included in Group I, patients treated with combination of SSZ (1-3 gr/day) and MTX (7.5-15 mg/week) in Group II, and patients treated with combination of SSZ (1-3 gr/day), MTX (7.5-15 mg/week) and HCQ (200 mg/day) in Group III. Forty-eight patients in Group I, 45 patients in Group II and III were eligible for statistical analysis at the end of study.

Results: The combination of MTX, SSZ, and HCQ, and the combination of MTX and SSZ were more effective regarding the clinical and laboratory parameters than SSZ alone (p<0.05). Moreover, the combination of MTX, SSZ, and HCQ was more effective than the combination of MTX and SSZ (p<0.05).

Conclusion: Combination therapies seem to be more effective and no more toxic than monotherapy in SpA patients with peripheral arthritis.