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Early shots delay rheumatoid arthritis progressionSep 02 09 – 03:24 PM
August 2009 ? According to a recent article published in the May/June issue of Arthritis Today, a new study suggests that a three week course of steroid injections given at the first signs of rheumatoid arthritis (RA) may prevent one in ten people from progressing to RA for at least one year.The earliest signs of rheu-matoid arthritis (RA) are often pain, stiffness and swelling in two or more joints (also called polyarthritis) in the hand. RA occurs when the body?s immune system attacks the joints and can lead to significant joint destruction and disability. It affects over 1.3 million people, including children, in the United States.
Polyarthritis is any type of arthritis which involves five or more joints, may be experienced at any age and is not gender specific.
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 these injections and half of those who did had RA. Further, 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 the results. (This does) not apply to people who have already had their arthritis for more than 12 weeks,? says investigators Deborah Symmons, MD and Susan Verstappen, PhD, of the University of Manchester in Manchester, United Kingdom.
Very interesting, thanks for sharing, Joe. Makes you wonder what other early interventions might be useful, too, like a very serious round of ABX.
But then again, the doctors kind of need to know what the early signs of RA look like, and believe me, 12 weeks would be miraculous. I had a bad knee for ONE NIGHT and nothing again for 10 MONTHS! So how can they even be sure their study really was within 12 weeks of onset? Moreover, I think I had other symptoms of the disease for many years before that, much like Dr. Brown talked about (fatigue, depression… etc.).
When I presented with SEVERE joint pain that was migrating rapidly after that 10 months, I was told by several doctors it was NOT RA. Most doctors (like an ER doc) will not know that RA shows up like this. And even when I insisted there was a problem, it took me another 4 months to get into a rheumy. So, if you can't recognize early symptoms and can't see a doctor rapidly, how can you treat them?
Also, those stats they give don't seem that conclusive to me either. You can't tell who will relapse a couple years down the line. At the one year point (after my initial knee incident), I was still a mystery with a negative RF and no other abnormal blood tests (the CCP might have been abnormal at that point, but they did not check that for another 6 months of me complaining). So, early intervention sounds much more plausible than it is in practice.
Maybe this research will improve that aspect of treatment. I sure hope so.
[user=20]Joe M[/user] wrote:
Early shots delay rheumatoid arthritis
Hi Joe–
The operative is “delay”. My neighbor's mother, long deceased, was put on steroids for her RA. Went totally into remission for I think 20 years–then it came back with a vengeance.
I am convinced that RA is of an infectious nature. Suppressing the disease and not eliminating the cause–I don't know, eventually you have to face the consequences.
Trudi
Lyme/RA; AP 4/2008 off and on to 3/2010; past use of quinolones may be the cause of my current problems, (including wheelchair use); all supplements (which can aggravate the condition) were discontinued on 10/14/2012. Am now treating for the homozygous MTHFR 1298 mutation. Off of all pain meds since Spring '14 (was on them for years--doctor is amazed--me too). Back on pain med 1/2017. Reinfected? Frozen shoulder?
These diseases are definitely sneaky, here today, gone tomorrow. 20 yrs is a long remission. In contrast, I had a friend who was on steroids from day one, and was put in a nursing home at the age of 35, in a wheelchair, blind in one eye and a prosthetic in the other. She died at the age of 42. We both had chicken pox at the same time, btw, as did another friend who also developed arthritis. I've always wondered about that. Anyway, I would love to have a 20 yr remission!
[user=20]Joe M[/user] wrote:
Early shots delay rheumatoid arthritis progressionSep 02 09 – 03:24 PM
August 2009 ? ……………….. At one year, 60 percent of those who did not get these injections and half of those who did had RA. Further, 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 the results. (This does) not apply to people who have already had their arthritis for more than 12 weeks,? says investigators Deborah Symmons, MD and Susan Verstappen, PhD, of the University of Manchester in Manchester, United Kingdom.
Joe, I can't remember the facts about your wife's dx, past treatments, etc. I do seem to remember she may be on Enbrel or similar drug and is doing well now. Is she now on AP at all, even a low pulsed dosage? I'm thinking she may not be on AP at this time. Could you clarify? I'm trying to figure out if she ever received any improvement while on AP, and how much both of you may have studied Dr. Brown's AP.
The above you posted may sound good, but must admit I'm skeptical. Instead, I'm wishing for physicians worldwide to learn about and begin testing soon for mycoplasma and/or other organisms (as Dr. Brown and others did/do, and finding a possible infectious cause; and, then, starting effective treatment for the organism).
In my experience with many patients who come to groups for help, so many of these have been treated with all kinds of drugs that have “first done them a great deal of harm” (one very slight patient/group member said her bones were literally crumbling). Dr. Brown did use and advocate small doses of pred & cortisone to make the patient more comfortable until AP kicked in.
If the above you posted turns out to be quite effective and not harmful, this will make me as happy as it does anyone else. Thanks for keeping us aware of what is going on.
AF
Tiff – with PRA the kinds of symptom treatment used for RA often dont work. NSAIDS never worked for me and this is pretty typical. I also once had a cortisone shot straight into the wrist joint in the very early days when I was in screaming agony. It didnt even touch the sides. And my bloodork all showed up as normal at the time. That is very typical of PRA – it seems to be a different manifestation to RA and many think a different disease. Lynnie
Be well! Lynnie
Palindromic RA 30 yrs (Chronic Lyme?)
Mino 2003-2008 100mg MWF - can no longer tolerate any tetracyclines
rotating abx protocol now. From Sep 2018 MWF - a.m. Augmentin Duo 440mg + 150mg Biaxsig (roxithromycin). p.m. Cefaclor (375mg) + Klacid 125mg + LDN 3mg + Annual Clindy IV's
Diet: no gluten, dairy, sulphites, low salicylates
Supps: 600mg N-AC BID, 1000mg Vit C, P5P 40mg, zinc picolinate 60mg, Lithium orotate 20mg, Magnesium Oil, Bio-identical hormones (DHEA + Prog + Estrog)Lynnie,
You are so right about the pain with PRA. I had absolutely no relief from NSAIDs or even vicodin when this first hit me. I wondered if morphine would even work. They totally didn't believe me at the ER though, so I just had to suffer. I think doctors should be aware that arthritis (whatever the final dx) manifests early in a huge variety of ways.
I thought it was interesting how they are using steriods. I'm not making a “cause” argument.
AP was OK for us for about a year, but too many flares/herxes and one big long one at the end was enough. Three weeks of prednisone until the Humira kicked in, and its going on four years of clinical remission and good labs, except for an Anti-CCP number that won't come down. I did the years of reading research articles, thinking surely they missed something and the answer was there somewhere. It's frustrating and exhausting and I pretty much gave up. I would like for them to find the exact cause and cure before I die. Not only for the sufferers but for my own curiosity! I'm not hopeful though, sorry to sound pessimistic. Now, I focus on the fact we found something that works real good and returned a quality of life we both though was seriously in jeapordy.
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