How is lupus treated?
There is no known cure for lupus, but there are treatments. Your treatment will depend on your symptoms and needs. The goals of treatment are to:
- Prevent flares
- Treat symptoms when they occur
- Reduce organ damage and other problems
Your treatment might include using medicines to:
- Reduce swelling and pain
- Prevent or reduce flares
- Calm the immune system
- Reduce or prevent damage to the joints
- Reduce or prevent organ damage
Drugs play an important role in treating lupus. Most likely, the drugs prescribed to you will change often during your treatment. Types of drugs commonly used to treat lupus include:
- Nonsteroidal anti-inflammatory drugs (NSAIDs).NSAIDs are used to reduce pain and swelling in joints and muscles. They can help with mild lupus—when pain isn't too bad and vital organs are not affected. Aspirin, ibuprofen, and naproxen are some over-the-counter NSAIDs. You need a prescription for stronger NSAIDs. NSAIDs can cause stomach upset, heartburn, drowsiness, headache, fluid retention, and other side effects. NSAIDs also can cause problems in your blood, liver, and kidneys if overused.
Corticosteroids.Corticosteroids are hormones found in our bodies. Manmade versions are used to reduce swelling, tenderness, and pain in many parts of the body. In high doses, they can calm the immune system. Often, these drugs are called "steroids." They are different than steroids used by some people who play sports or lift weights. Corticosteroids come as pills or liquids, creams to apply to the skin, and as a shot. Prednisone is one drug commonly used to treat lupus. Lupus symptoms tend to respond very quickly to these powerful drugs. Once this has happened, your doctor will want to lower your dose slowly until you no longer need it. The longer a person uses corticosteroids, the harder it becomes to lower the dose. But stopping this medicine right away can harm your body. Make sure to use your medicine exactly as your doctor tells you to.
Corticosteriods can have many side effects, so your doctor will give you the lowest dose possible. Short-term side effects can include: a round or puffy face, acne, heartburn, increased appetite, weight gain, and mood swings. These side effects typically stop when the drug is stopped. Long-term side effects can include: easy bruising, thinning skin and hair, weakened or damaged bones, high blood pressure, damage to the arteries, high blood sugar, infections, muscle weakness, and cataracts. Your doctor can prescribe medicines to take with corticosteroids to prevent some side effects, such as osteoporosis.
- Antimalarial drugs.Medicines used to prevent or treat malaria are used to treat joint pain, skin rashes, and mouth sores. Two common antimalarials are hydroxychloroquine (Plaquenil®) and chloroquine phosphate (Aralen® phosphate). Side effects of antimalarials can include stomach upset, nausea, vomiting, diarrhea, headache, dizziness, blurred vision, trouble sleeping, and itching.
- Immunosuppressive agents/chemotherapy.These agents are used in severe cases of lupus, when major organs are not working well and other treatments do not work. These drugs suppress the immune system to limit the damage to the organ. Examples are azathioprine (Imuran®) and cyclophosphamide (Cytoxan®). These drugs can cause serious side effects including nausea, vomiting, hair loss, bladder problems, decreased fertility, and increased risk of cancer and infection.
You and your doctor should review your treatment plan often to be sure it is working. Tell your doctor about any side effects or if your medicines no longer help your symptoms. Tell your doctor if you have new symptoms. Never stop or change treatments without talking to your doctor first. Also, it is likely that you will need other drugs to treat conditions that are linked to your lupus—such as drugs to treat high blood pressure or osteoporosis.