Lupus or systemic lupus erythematosus (SLE) is a chronic autoimmune condition where your immune system sees your own tissues as foreign cells and therefore starts to produce antibodies against them. Since the antibodies are produced by your own cells, these antibodies are given the term "autoantibodies."
The autoantibodies attack all systems in your body including your skin, eyes, brain, heart, joints, kidneys, and the digestive tract, which ultimately results in the inflammation of body tissues causing pain, tiredness, and rashes.
Lupus is an episodic disease, meaning, it has periods where you are completely fine and times where symptoms reappear. The periods when you are completely fine are known as "periods of remission" whereas the periods with recurring symptoms are called as "flares."
The symptoms of lupus vary from one individual to another. Hence, the best treatment approach is for the patient to undergo laboratory tests and monitoring his or her condition with a health care team that will customize a treatment plan according to his or her specific condition.
Today, around the world, physicians treat lupus using a wide variety of medicines, which can range in strength and dosage from mild to extremely strong. Prescribed medications will usually change during a person’s lifelong journey with lupus, depending on the severity and the improvement of the symptoms. However, it can take months and even years before your health care team finds just the right combination of medicines to keep your lupus symptoms under control.
While there is no cure for lupus, an early diagnosis and a customized treatment plan can help in managing the symptoms as well as lessening the chance of permanent damage to the affected organs or tissues.
Because lupus is different in every person, treatment and medications are prescribed based on the individual's needs.
For mild cases of lupus or for patients who are diagnosed with lupus in the initial stages, medicines may include over-the-counter pain relievers and anti-inflammatory medicines to control the symptoms of the disease. For a more severe lupus, or when the internal organs are affected, which is proven by running pathological tests, the health care team will give stronger prescription drugs to soothe the immune system and protect the organs such as the kidneys, heart, and lungs from further damage.
Once you have been diagnosed with lupus, your doctor will develop a treatment plan based on your age, symptoms, general health condition, diet, and lifestyle. The goals of any treatment plan prescribed by the health care team are given to help in:
- reducing the inflammation caused by lupus
- suppressing the overactive immune system
- preventing flares and treating them when they occur
- controlling symptoms like joint pain and fatigue
- minimizing damage to the affected organs
People with lupus often require other drugs to treat other symptoms that are commonly seen with the disease. The drugs include:
- diuretics for fluid retention (fluid retention causes the blood pressure to go up)
- antihypertensive drugs for high blood pressure
- anticonvulsants for seizure disorders
- antibiotics for infections
- bone-strengthening drugs for osteoporosis
Until now, there is no proper cure for lupus. Its symptoms can only be controlled with certain medications. The drugs used to control the signs and symptoms are discussed below.
Corticosteroids, glucocorticoids, or steroids are drugs that help regulate your immune system. They mimic the action of cortisol. Cortisol is a stress hormone produced in your body that helps in the reduction of body inflammation and controls your immune system. By mimicking the action of cortisol, steroids control the immune system, reducing the symptoms caused by lupus.
Prednisone, cortisone, and hydrocortisone are some of the commonly used steroids in the treatment of lupus. Like any other drug, steroids also have side effects. Some of the most common side effects are weight gain, osteoporosis, acne, infections, and sleeping problems.
Due to these side effects, your doctor will always prescribe the smallest effective dose for a short period of time. You should never stop taking your steroid pills without consulting your doctor. Your doctor will slowly tail off the steroids with time to minimize the risk of side effects.
Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)
NSAIDs are over-the-counter pain medications which are used to reduce pain as well as inflammation and stiffness in your body. Some of the over-the-counter NSAIDs are aspirin, ibuprofen, and naproxen. Certain NSAIDs are available only with prescriptions and these include celecoxib, diclofenac sodium, mefenamic acid, etc.
The side effects of using NSAIDs include stomach ulcers, bleeding into the stomach, nausea, and heartburn. One of the most common side effects is stomach ulcers. Therefore, care should be taken when taking NSAIDs for a long period of time. The risk can be reduced by taking NSAIDs with your meals and never taking them before going to bed or lying down.
Acetaminophen also helps in reducing pain and bringing down fever. It has fewer intestinal side effects but can cause kidney and liver problems. Therefore, consult your doctor before taking acetaminophen, especially if you have kidney disease.
Opioids such as codeine and oxycodone are powerful painkillers that are prescribed if NSAIDs and acetaminophen fail to provide pain relief. These drugs are prescribed lastly due to the risk of addiction.
Disease Modifying Anti-Rheumatic Drugs (DMARDs)
DMARDs are drugs that are used in the treatment of autoimmune diseases. They reduce the activity of the immune system, thus, reducing the lupus symptoms.
As the name suggests, antimalarial drugs are used to treat malaria. However, these drugs can also be used in treating lupus by reducing the production of autoantibodies. These drugs take some time to act, therefore, they are only given when other medications fail to work. These drugs have fewer side effects but can cause vision problems in some patients. For this reason, if you are taking antimalarial drugs, your doctor will advise you to get your vision checked.
Throughout the world, researchers in the medical field are intensively looking for new alternative medicines for people with lupus. Innovative research in human tissues may also drive the discovery of new therapies. Stem cell therapy is also being discussed as an effective treatment option. However, getting a medical advice is immensely important and crucial if you have a confirmed lupus diagnosis.