Lupus is a chronic autoimmune disease. In autoimmune diseases, your immune system attacks itself. Lupus causes the immune system to mistake healthy tissues for germs, viruses, and other invaders. The system then creates autoantibodies that attack your body’s own organs. This attack can affect many parts of your body and often causes symptoms such as joints, organs, eyes, and skin. It can cause pain, inflammation, fatigue, and rashes. The condition goes through times when it’s more active, which are called flares or flare-ups. You may have more symptoms during these periods. Lupus also goes through times of remission. These are times of decreased activity when you may have fewer flare-ups. Unfortunately, there’s no cure for lupus yet, but certain drugs can ease your symptoms. To get started, learn about the types of medications that can treat your lupus symptoms.
What are steroids, and why are they used to treat lupus?
Steroids are a group of chemicals that make up a large portion of the hormones in your body. One of these steroids, cortisone, is a close relative of cortisol, which the adrenal glands in your body make as a natural anti-inflammatory hormone. Synthetic cortisone medications are some of the most effective treatments for reducing the swelling, warmth, pain, and tenderness associated with the inflammation of lupus. Cortisone relieves these symptoms. However, cortisone can also cause many side effects, so it is usually prescribed only when other medications are not sufficient enough to control lupus.
Steroids are synthetic prescription drugs designed to work like the body’s naturally occurring hormones produced by the adrenal glands, in particular cortisol. Hormones are the body’s chemical messengers that regulate most of the body’s functions. Cortisol helps regulate blood pressure and the immune system and it is the body’s most potent anti-inflammatory hormone. Steroids prescribed for autoimmune diseases are different from the anabolic steroids that weightlifters and other athletes sometimes take to increase strength.
Steroid medications work quickly to decrease the swelling, warmth, tenderness and pain that are associated with inflammation. They do this by lessening the immune system’s response. Prednisone is the most commonly prescribed steroid for lupus. Prednisolone and methylprednisolone are similar to prednisone. Some physicians prefer to prescribe these if you have liver problems.
Most people take steroids in pill form, but topical creams or gels are often used to treat skin lupus. Steroids in liquid form are sometimes injected into muscles or directly into joints and in some cases into skin lesions. Pulse steroids are large liquid doses given intravenously over several hours. Consequently, the beneficial effects can last for weeks, so pulse steroids are sometimes prescribed to control a lupus flare or for people who cannot tolerate steroids in pill form.
Steroids can produce a variety of side effects, including:
- A round or moon-shaped face, weight gain or hair growth
- Fragile skin that bruises easily.
- Suppressed growth in children.
- Irritability, agitation, excitability, insomnia or depression.
What steroid medications are commonly prescribed for lupus?
Prednisone is the steroid most commonly prescribed for lupus. It is usually given as tablets that come in 1, 5, 10, or 20 milligram (mg) doses. Pills may be taken as often as 4 times a day. Usually, a low dose of prednisone is about 7.5 mg per day or less, a medium dose is between 7.5 and 30 mg per day, and a dose of more than 30 mg qualifies as a high dose. Your doctor may also prescribe a similar drug called prednisolone, especially if you have had any liver problems. Prednisolone and prednisone are very similar. In fact, the liver must convert prednisone to prednisolone before the body can use it.
With the evolution of knowledge that has come about concerning lupus, it is clear that for most patients, a normal and active life is entirely possible. Even in those patients going through a long and seemingly endless flare of disease, improvement of disease is highly likely so don’t lose hope!