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 (doubleblind) to SSZ or placebo treatment, and followed up for 36 weeks. Treatment response was based on joint p a i d Address reprint request requests to Daniel 0. Clegg, MD, Division of Rheumatology, 4B200-SOM, 50 North Medical Drive, Salt Lake City, UT 84132.Submitted for publication March 19,1996; accepted in revised form July 19, 1996. tenderness and swelling scores and physician and patient global assessments.Resubs. 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.Conclusion. 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.
The renin-angiotensin system (RAS) plays a crucial role and angiotensinogen levels, this relationship persisted in the regulation of fluid volume, thereby influencing for ACE in multivariate analyses controlling for BP, blood pressure (BP). Obesity is an important risk factor hypertension status, age, and gender. The for hypertension, however the physiologic basis for this insertion/deletion polymorphism of the ACE gene was relationship has not been clarified. In a population surassociated with variation in the levels of ACE, but inconvey we examined the potential relationship between the sistently with body mass index. Variants of the angio-RAS and obesity. Based on community sampling, 449 tensinogen gene leading to amino acid substitutions at individuals were recruited from metropolitan Kingston, positions 174 and 235 did not influence levels either of Jamaica. Serum angiotensin-converting enzyme (ACE) angiotensinogen or obesity. These data suggest that and circulating angiotensinogen levels were measured obesity may alter the levels of ACE and angiotensinand the associated genes were typed for previously ogen, and provide a potential pathway through which described polymorphisms. Obese individuals (body obesity leads to elevation of BP. mass index Ͼ31) had significantly higher serum ACE
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