How is lupus treated?

Although life expectancy doesn’t change in 95% of systemic lupus cases, it is important to make a diagnosis early so that therapy can begin with an aggressive management of the condition.

Treatment involves steroid anti-inflammatories (NSAIDs) or COX-2 inhibitors as well as other common medication depending on the patient. Drugs such as beat-blockers and hydralazine should be avoided for patients with hypertension as they can cause drug induced lupus. Side effects such as a skin rash and a serious low white blood cell count can be caused by other drugs such as sulfonamides. The family doctor is typically the one to prescribe the medications however a rheumatologist may also be involved in the treatment plan.

For non specific symptoms such as headaches, joint pains and chest wall pains simple pain pills are used. Blood pressure must be measured regularly, as lupus patients have very sensitive kidneys and will experience kidney damage.

There are newer treatment options at the horizon such as weak testosterone-like agents and prolactin inhibitors. A better understanding of these methods may lead to a more frequent use of these treatment modalities.

It should be the rheumatologist who decides which treatment modality is the best for a certain patient as the side effects of any of these treatments have to be carefully monitored.

The following list includes common medications used to treat lupus as well as their benefits and side effects.

Medication: Benefits and side effects:
NSAIDs Helps with joint pains. Possible stomach irritation, bleeding ulcers and kidney damage; non drug IceWave patches from Lifewave are also useful for pain control
COX-2 inhibitors More tolerated than NSAIDs, but long term use also leads to some stomach irritation.
corticosteroids Used as a disease modifier; chronic use leads to infections, osteoporosis with fractures and possibly cardiovascular disease
Hydroxychloroquine An anti-malarial drug that stabilizes lupus
immunosuppressive drugs Reserved for organ involvement such as kidneys, heart, lungs. An immune-suppressant that can cause fevers (eg. azathioprine, methotrexate or cyclophosphamide)
anticoagulants Used in cases of lupus with antiphospholipid syndrome where clots are prominent
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