How is lupus treated?
The type of treatment prescribed will depend on several factors, including the person's age, type of medications he or she is taking, overall health, medical history and location and severity of disease.
Because lupus is a condition that can change over time and is not always predictable, a critical part of good care includes periodic visits with a knowledgeable, available physician.
Some patients with mild features of the disease do not require treatment, while patients with serious involvement (such as kidney complications) may require the use of powerful medications. Medications used to treat lupus include:
- Steroids or prednisone and related derivatives of cortisone. Steroid creams can be directly applied to rashes. The use of creams is usually safe and effective, especially for mild rashes. The use of steroid creams or pills in low doses can be effective for mild or moderate features of lupus. Steroids can also be used in higher doses when internal organs are threatened. Unfortunately, high doses are also most likely to produce side effects.
- Hydroxychloroquine (Plaquenil®) is commonly used to help keep mild lupus-related problems, such as skin and joint disease, under control.
- Cyclophosphamide (Cytoxan®) is a chemotherapy drug that has very powerful effects on reducing the activity of the immune system. It is used to treat severe forms of lupus.
- Azathioprine (Imuran®) is a medication originally used to prevent rejection of transplanted organs. It is commonly used to treat the more serious features of lupus.
- Methotrexate (Rheumatrex®) is another chemotherapy medication used to suppress the immune system. Its use is becoming increasingly popular for skin disease, arthritis, and other non-life threatening forms of disease that have not responded to medications such as hydroxychloroquine or low doses of prednisone.
- Cyclophosphamide (Cytoxan®) and mycophenolate mofetil (CellCept®) are chemotherapy drugs that have very powerful effects on reducing the activity of the immune system. They are used to treat more severe forms of lupus, especially lupus that affects the kidneys.
- Belimumab (Benlysta®) is a monoclonal antibody that reduces the activity of white blood cells (lymphocytes) that make autoantibodies. Autoantibodies are important as they cause tissue damage. Belimumab is used to treat lupus that does not involve the kidneys and has not responded to other types of treatments.
- Rituximab (Rituxan®) is also a monoclonal antibody that reduces the activity of white blood cells (lymphocytes) that make autoantibodies. It is sometimes used to treat lupus that has not responded to other types of treatments.