Efficacy And Safety Of Mesalazine And Sulfasalazine In The Treatment Of Spondyloarthritis: A Meta-Analysis Of Randomized Controlled Trial

Objective: This study aimed to evaluate the clinical efficacy and safety of mesalazine and sulfasalazine in the treatment of Sp A.Methods: Literatures comparing the clinical efficacy and safety of mesalazine and sulfasalazine in the treatment of Sp A were retrieved from Pub Med,Elsevier,Embase,China National Knowledge Infrastructure(CNKI)and Wanfang database(the search time was from the date of their establishment to October 31,2018).The researcher filters references retrieved from the databases.The quality of the included studies was determined independently by two evaluators and the data were extracted independently using a specially designed data extraction table.Finally,the Review Manager 5.3software provided by Cochrane Collaboration was used for data analysis.The main outcome indexes were CRP,ESR,morning stiffness duration,pillow wall distance,and finger-ground distance.The security indexes were incidence of adverse events,withdrawal rate related to adverse reactions and total withdrawal rate of loss of follow-up.Results: A total of 6 literatures were included in this Meta-analysis,all of which were case control study.The total sample size: 387 cases,2 literatures in English and 4literatures in Chinese.The quality of the included articles was evaluated,and the Rev Man software was used to draw forest map for analysis.The Meta analysis results showed that: 1.The decrease of ESR in the mesalazine group after treatment was more significant than that in the sulfasalazine group,and the difference was statistically significant [OR =-3.26,95% CI(-5.87,0.65),P =0.01].2.Both the mesalazine group and the sulfasalazine group showed significant improvement in CRP compared with that before treatment,and the difference was not statistically significant [OR =-0.06,95% CI(-0.42,0.29),P =0.73].3.The morning stiffness time of the mesalazine group after treatment was significantly lower than that of the sulfasalazine group,with statistically significant differences [OR =6.00,95% CI(1.61,10.39),P =0.007].4.The incidence of adverse reactions in the mesalazine group was significantly lower than that in the sulfasalazine group,with statistically significant differences [OR =0.41,95% CI(0.24,0.71),P =0.001].The ESR,CRP,BASDAI,morning stiffness time and global assessment of the experimental group and the observation group were significantly improved compared with those before treatment,while the adverse reactions in the experimental group were significantly reduced compared with the observation group.Conclusion: Mesalazine also has a significant effect on the treatment of Sp A,and there is no significant difference between mesalazine and sulfasalazine.In terms of adverse reactions,mesalazine also exists,but the incidence of adverse reactions is significantly lower than that of sulfasalazine.