Six trials involving 468 patients were included in a Cochrane review . A statistically significant benefit was observed for sulfasalazine when compared to placebo for tender and swollen joint scores, pain, an ESR. The standardised weighted mean difference between treatment and placebo was -0.49 (95% CI -0.75 to -0.36 and -0.79 to -0.12 respectively) for tender and swollen joint scores, and -0.42 (95% CI -0.72 to -0.12) for pain. The weighted mean difference for ESR was -17.6 mm (95% CI -21.93 to -13.23). Withdrawals for adverse reactions were significantly higher in the sulfasalazine group (OR 3.0).