Does early sulfasalazine treatment provide long-term benefits to patients with juvenile idiopathic arthritis?

The small, well-designed, observational study by van Rossum et al. raises and addresses questions of great significance for the treatment of children with JIA. The original RCT demonstrated significant benefits of sulfasalazine over placebo that, by today's standards, would be considered only moderate clinical improvement. Despite these initial modest effects, the sulfasalazine group demonstrated improved outcomes compared with the placebo group 9 years later.