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Conditions > Rheumatoid Arthritis > Rheumatoid Arthritis Treatment > Slowing Rheumatoid Arthritis Progression
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Slowing Rheumatoid Arthritis Progression

By Denise Lynn Mann

The earliest sign of rheumatoid arthritis (RA) is often pain or swelling in two or more joints, especially if one of those joints is in the hand.

Doctors call this polyarthritis, and now a new study suggests that a three-week course of steroid injections given at this very early stage may prevent 1 in 10 people from progressing to RA for at least one year.

The Steroids in Very Early Arthritis (STIVEA) trial divided 265 people who had polyarthritis for less than 12 weeks into two groups, one that got steroid injections and one that got placebo shots.

At one year, 60 percent of those who did not get steroid injections and half of those who did had rheumatoid arthritis. What's more, 10 percent of people in the placebo group were arthritis-free at one year, compared with 20 percent of people who received steroids.

“The earlier the treatment, the better [as] the trial results do not apply to people who have already had their arthritis for more than 12 weeks,” say lead authors Deborah Symmons, MD, and Suzan Verstappen, PhD, of the University of Manchester in Manchester, United Kingdom. The study was presented at the annual congress of the European League Against Rheumatism 2008 meeting in Paris.

Now the group is looking to see if there are any genetic markers in the blood that may predict which people with polyarthritis are most likely to respond to steroids.

Gerri
12 Aug 2010, 13:33
I was lucky my GP recognized right away I had RA and send me to a rheumatologist but it took 8 months to get an appointment to see him. I just woke up one day and I was stiff and it stayed that way for many days. He put me on 5 mg prednisone once a day and 1000 mg of planquinil once a day. I have been free of pain for 10 years and recently my hands started swelling. He then put me on 3 2.5 methotrexate tablets once a week, along with everthing else. My blood work recently showed my liver and kidney function were low. I started drinking plenty of water, 6-8 glasses a day, and the last blood tests shows both are in range now, doing good. I have been taking prednisone for 10 years and am working on getting off of it, the skin on my arms are a mess, I bruise just hitting anything lightly. Has anyone come across anything that takes the place of prednisone that works?
Billy
08 Jun 2010, 20:17
I was just diagnosed with RA today after going 5 monthsbeing told i had Gout. Its gonna be very hard but i think i can make it.
Bonnie Nichols
10 Jan 2010, 17:13
To Gina in answer to your inquiry about Remicade. I had been thru several medications and needed more help My dr. put me on Remicade injections which was an IV drip for about 2 hours. For a whole year I had just one infection right after another including the shingles. Sometimes the infec- tions would come one on top of another. I'm sure it would not be the same for everyone, but that was my experience. I have been on Prednisone for a couple of years and it seems to control the pain better with fewer side effects. I still have flare-ups once in awhile, but increasing the doseage for as little as 1 day gets me past the pain. Hope this helps!
STEPHANIE
23 Dec 2009, 18:47
Lesley, I would love to get in touch with you. I am 32 and was diagnosed with RA at 4 and epilepsy when I was 12. I have never met someone who has both complications. I am in the middle of a storm with both illnesses. My epilepsy was controlled for 18 years and the medication caused me to develop Polycystic Ovarian Syndrome as a side effect. My neurologist and I have not been able to control siezures yet. I am doing the horrific switch-a-roo med game and side effects and withdrawals are terrible. I had my third hip replacement last year and found out wednesday I need a shoulder replaced. Doc and I want to wait until siezures are controlled again. I'm battling depression along with this and trying to be a college student.
Helen
21 Dec 2009, 22:35
I was diagnosed today as having polyarthritis.
I have had problems with my left hand for two years. During those two years, I saw a Hand specialist, two physical therapists, a chiropractor & a massage therapist. Nothing helped & it took forever to get appointments. Now my right hand is hurting & feels swollen. I received a prescription for Methotrexate (2.5) & Folic Acid (1 mg). I'm a beginner but I hope to learn from other's experiences so we can be a chain of comfort to others.
Lesley
19 Oct 2009, 20:31
P.S. to my last post. I did not mean to disregard prednisone as a drug that can assist in treatment. It is very helpful when having flair-ups, or during the waiting period for a new drug to take effect. But, prednisone over the long term, as the only tx, can do alot more harm then good. I am a nurse, but believe me I'm with Glow, it hit me hard too, and I was scared to death. I have had RA for 18 years, and it is well managed. Linda, I had that experience with a drug not working anymore, fortunatley, you have other options today. This is not uncommon by the way. I am only 8 years away from medicare, paying for all these drugs is a scarry thought. I also have epilepsy, diagnosed 5 mths ago. my husband has a great health plan, but if that changes, I am in big trouble. I am starting to investigate options, but who knows what healthcare will look like in 1 year, let alone 8!


Please, Please, Please. Anyone who is being treated with prednisone as their only method of care, run!!! find a new doc. There is no reason for you to be in pain, and you should see a slowing of changes with the meds out there today. Go to a rheumatologist, they truly understand this elusive disease, It is very specialized. Many drugs work better when prescribed in conjunction with another. For instance I took mtx with plaquenil, I had shortness of breath, and was weak and tired all the time. However, when the dose of mtx was reduced and I used in conjunction with enbrel, I had success, and the shortness of breath and other symptoms resolved. Granted no two people react the same to medications, or a grouping of meds. But I am sure of this, you should be working with a doc who willing to try everything to get you to a place where you slow bone changes, and stop the pain! My sed rate was through the roof, I could not walk. My entire body hurt. I couldn't sleep, I couldn't,stay up. I cried all the time from the frustration and pain. I could not be the mother I wanted to be, and no one could really understand my suffering(since it took about seven years for my joints to show changes). I looked "normal" to everyone so what was the problem? RA. I have been pain free, and while I have had some significant joint changes in my hands and feet, they don't hurt! unfortunatley, some of the newer drugs were not on the market yet when the changes in my joints started to appear. I am typing now without pain. I cook, sew, work, etc. I still get tired a little more then people without RA, but I will take that! Try everything, what works for me may not work for you, doses may need to be adjusted, etc. I know that some people have stomach issues with alot of the RA drugs, I am lucky, I don't. I have my blood work every two months, and everything is great! including the liver. I am a high risk medication patient, so bloods should be drawn every two months for this reason. I will share with you what I take, but keep in mind, we all respond differently to every med. I take (enbrel 50mgs inj. weekly), (75mgs twice a day-voltaren), (500mgs twice a day.-azulfidine), (2.5mgx5 once a week mtx), no folic acid that day. I find that for me taking my enbrel the day after mtx, works the best, and taking mtx before bed, helps some with any stomach upset they might have, just a thought. It could be in my head, but it works, so I do it. (folic acid 1mg- daily. I stay hydrated and try to keep my weight down which also helps the joints. I recently had both feet operated on, it went very well, and I now have 2 feet that look and feel terrific. I will soon beable to wear regular shoes like the rest of the population. I wish you all the best on this forum, and please, you are the best advocate for yourself, no one else!
Judy
07 Oct 2009, 10:12
I started having wrist pain in 1 wrist 7 years ago. I was 48. GP put me in a brace and steriod shot for six weeks. By then my 2nd wrist was hurting. More steriod injections. I was sent to Rheumatologist. I have gone through Celebrex, Meloxicam, Plaquenil, Methotrexate, Daypro, .......Those kept me going and working until 2 years ago. I hurt my back and I am "disabled". One year ago I changed Rheumatologists because I knew my symptoms were progressing and my fatigue was really bad. I knew I was not "lazy". I had been a working women all my adult life. I did not feel my dr. was doing enough for me. I'm so glad I changed doctors. I started Remicade infusions, every six weeks and take Daypro and Prednisone 5 mg/day. I lived in denial for years. People, stop denying you have the disease and do what you have to do for the best quality of life. Take your doctor's advice. If I had heart disease I would go to a Cardiologist and certainly follow his advice. Why not my Rheumatologist?
Amber Star
27 Sep 2009, 17:35
Last December 2008 my right hand (pointer finger and middle) were extremely swollen and red. My primary doc was out of town so I stopped at one of the little clinics and saw a physician there. His dx was gout which surprised me greatly. However, my uric acid level was high. I didn't know what to do after they called with the labwork. I waited until my primary got back and he went along with the other dx. He put me on prednisone, chlorquine, and something that really didn't work. Finally he got me an appt with a rheumatologist who took the whole thing seriously, did a battery of tests, and put me on Methotrexate, plaquinil, prednisone, folic acid, a ton of vitamins. My vit D level was half of what it should be. I was surprised by that.
Some days are better than others, but he feels that I'll feel a lot better than I do now and now is great compared to how I felt before and after Christmas. It was such a relief to find that there was a reason I was tired and not just lazy. Well, some lazy but not like when I'm having a flare.

This is the 9th month of for sure knowing there was something wrong and about 4 months of knowing what was wrong. I haven't noticed a real change with diet. But getting enough rest is very important for me.
Sharon Troxel
17 Sep 2009, 13:02
I was treated with prednisone at first and then plaquenil soon after being diagnosed with RA. My only symptom was fingers on both hands being very stiff and sometimes freezing. They still are very stiff, mostly in the morning, but don't freeze anymore. But I have been having trouble with my jaw for some time and not thinking that it was RA I didn't go to the doctor right away. After seeing a specialist he says my jaw will have to be replaced in coming years. I am going to have a cortozone shot in it next week but I am upset as I thought the plaquenil was preventing this to happen. I am only 61 and fear for the quality of life I have ahead of me.
Gina
25 Aug 2009, 19:37
Well i have had pain in my hands,feet and shoulder for at least 6months.I am on folic acid,methotrexate2.5 and etodolac.Now in the beginning when i was told i had RA i was watching everything i would eat no salty food and very little meat i did really well i felt great now i quit watching my diet now i hurt.The doctor once me to go on enbrel or remicade.Does anyone know anything about these meds or have you tried them.
TONI
10 Jul 2009, 16:58
I HAVE HAD R/A FOR 4 YRS NOW ON METRO 2.5 MG 1 TIME A WEEK TRYED HUMIRA 1TIME WEEK SHOT GOT LUNG INFECTION. THEN EMBRIL 1 SHOT 1 TIME WEEK SAMETHING LUNG INFECTION.THEN REMACADE INFUCTIONS 1 TIME MONTH LUNG INFECTION.NOW HE WONTS ME ON ORENCIA INFUCTIONS 1 TIME A MONTH NOW WHAT SHOULD I DO . IM ON 5MG PREDISON 1 TIME A DAY I FELL GOOD.I SMOKE I KNOW IF I QUITE I WOUNT GET LUNG INFECTIONS ANY MORE THANKS FOR SHARING
Lucy
08 Jul 2009, 12:53
I got the RA at age 80. At 81 I had to quit alpine skiing (after 57 yrs.) and also gave up x/c skiing,as it hurt my wrists and hands and made my shoulders ache. Also quit ballroom dancing because of all the hand pulling. I finally saw a rheumatologist and got the diagnosis and was put on prednisone and n-saids. I had a bladder infection, so other medication couldn't be started. Finally I was put on methotrexate low dose and kept increasing it. This medicine never did me any good unless I also took the prednisone (dose 10mg. 2x a day.) I heard so many bad things about all the RA drugs side effects that I have just staid on the prednisone and n-saids, but I can't get the dosage down to 5mg 2x a day, which I have read you can be on for a long period of time. After 2 days on the 5mg 2x day, I start having more aches. I still bike ride around 9 miles 3x a week and go to a spa a couple of times. I can button, snap and hook things. I still sew on the machine and can pick up pins, etc. I seem to do better when the weather is good. In really bad, cold weather I may have to sleep with ice on my neck. The side effects of prednisone do not seem to contain terrible information on liver, kidneys, lungs going bad and even death. I have always eaten a really good diet--no junk food--and am taking other foods away like red meat, cows milk products, tomatoes, glutens, etc. I notice a difference if I eat anything not good for me. Lucy
Ann
16 Jun 2009, 14:41
My arthritis came on suddenly, the day after I had a remedial massage, which seemed too much of a coincidence for it not to be connected. It started in my knees and spread from my jaw down to toes, I eventually had to crawl upstairs, couldn't sit for long, couldn't write and there was no way I could put my shoes on, within 9 weeks I was admitted to hospital for almost 3 weeks. Previously I had all the blood tests taken and one GP said I was very lucky it wasn't RA. The Hospital Consultant thought it might be a viral arthritis and started me on steroids straight away,through a drip and slowly I could feel my fingertips coming back to life within half an hour, I was told that years ago they would leave it some time before they put people on steroids, but certain tests showed that it was better to start them straight away. I was fairly young at the time and it took a long time for me to accept that I had that disease. Anyway I was told it was Sero-negetive Arthritis and if i still had it after five yrs it would stay with me. I left hospital with 15 tablets to take a day, on steroids for 10 months. It's almost 14 yrs since it started and I've had flare ups and know when to take it easy and if I didn't have a whole lot of other health conditions I could live with the RA. My test for RA has changed to positive. I've been on sulphasalazine since then, but with my liver function not very good and my joints seem to be deterorating, (although fortunately they are not mishaped, but I get a lot of pain) my medication may soon be changed. I feel lucky that I have never had it so bad as 14 yrs ago and that is down to the medication prescribed to me. I didn't stay with the first hospital as they wanted to put me on loads of different drugs including 'GOLD' and I said no and my GP sent me to a new hospital and they took me off a lot of the drugs I was on that was causing some of the pain I was experiencing. I would say to people to take note on what the medical people tell you, but you don't have to always do what they want.
margo setti
01 Jun 2009, 12:40
it took 13 months for my doctor to finally realize it wasn't reactive arthritis. We tried all kinds of meds with no results,from nsaids to plaquenil,and steroids. I am now going to see another doctor. this doctor refused my opinion of rheumatoid arthrits from the very beginning.It's been a horrible year
Brigitte
18 May 2009, 22:03
It took just 1 week to diagnose my RA through bloodtests. I had gon to see the dr. when I couldn't open my finger and had alot of swelling on the top of my hand. The Rheumy appt. took 2 month to get.
Yolanda
02 May 2009, 12:44
This is all good news. However, it is predicated on an early diagnosis. I would like to know how many RA patients actually receive a diagnosis within 12 weeks of onset of symptoms?

My symptoms started in my knees. My GP thought fibromyaligia, maybe, maybe not. But I received no treatment options during months of guesswork. I finally got an appointment with a rheumatologist - 2 1/2 months out. It took me 6 months of agony to get a diagnosis.

Too many GP's and Internists, I feel, are either not equiped or not in the mind set to recognize these early symptoms as being significant. They want to wait and see, try ibuprofen - in the meantime, the disease takes hold.

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