Sulphasalazine - An alternative drug for second-line treatment of juvenile chronic arthritis

Sulphasalazine has been established to be an effective drug for second line treatment of early mild to moderate rheumatoid arthritis. Its application for juvenile chronic arthritis (JCA) is limited so far and controversial results for the efficacy of this therapy have been published. We studied the efficacy and tolerance of the sulphasalazine treatment in 32 patients with JCA (10 with polyarthritis, 21 with pauciarthritis and 1 with systemic form). Our results revealed significant response of the treatment at the end of the 6(th) month in 24/31 patients (77%). In one patient the treatment was discontinued because of transitory neutropenia at the end of the 1(st) month. No significant difference was observed between the efficacy of the treatment in the polyarticular and pauciarticular disease, as well as newly-diagnosed cases and those with longstanding disease. From the group of 17 children treated up to the end of the 1(st) year 88% achieved complete remission. No serious toxic effects were observed, with the exception of two cases with transitory low-grade neutropenia. According to our results surphasalazine is an effective and well tolerated drug for second line treatment of JCA-patients.