10/12/09 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.