Treatmet for Lupus

For most people with lupus, proper treatment can minimize symptoms, reduce inflammation and pain, and stop the development of serious organ damage. The information found here will help you understand the most commonly prescribed medicines today, and other drugs under investigation for treating lupus.

Treatments for Lupus
Health professionals continue to search for better ways to care for and treat people with lupus. Understanding what causes the disease and why certain people are more likely to develop it may one day lead to promising new treatments for, or even prevention of, lupus. In the meantime, researchers continue to look for new treatments and ways to modify existing ones so they can diminish or eliminate side effects and improve the quality of life for people who have lupus.

Medications to Treat Lupus Symptoms
Medications are important for managing many systemic lupus erythematosus (SLE) patients. An array of drug therapies is now available, and this has increased the potential for effective treatment and excellent patient outcomes. This section will discuss the use of Anti-Inflammatories, Corticosteroids, Antimalarials, Immunosuppressives medication and Anticoagulants in the treatment of your lupus symptoms.

Investigational Treatments for Lupus
People with serious illnesses who are not responding to already available treatments sometimes enroll in clinical trials to gain access to medical treatments that could be helpful. Here you will find information on Biologics, Hormones, Immunosuppressives (Immune Modulators), Monoclonal Antibodies, Organ Transplant Anti-Rejection Drugs, Stem Cell Transplantation and Tropical Immunomodulators (TIMs) therapies.

The Best Approach to Taking Medications
Knowing your medications and being careful to take them as prescribed can sometimes be a daunting task especially if the side effects seem to be worse then the lupus disease itself. This section will discuss how you and your health care team can work to develop the best treatment plan for you. Open communication and knowledge is the best approach to managing your lupus.

Complementary and Alternative Medicines and Therapies
This section looks at the role of complementary and alternative medications as a balanced approach to the management of lupus. Before you add herbs, dietary supplements, or vitamins to your diet, discuss this with your doctor, as these products may interact with drugs used to treat lupus. Dietary supplements should never be used to replace medicines prescribed to control lupus symptoms or medication side effects.

Center for Clinical Trials Education (CCTE)
There has not been a drug approved specifically for the treatment of lupus in more than 40 years. There are a variety of reasons for this. Some are due to the complexities of the disease itself, as well as how clinical trials are designed and completed. This section will provide you with information on how Clinical Trails are increasing the understanding of lupus and the development of new treatments.

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Ask the Experts
Check out the LFA "Ask the Expert" archives and learn more about lupus on a variety of topics including skin issues, pregnancy, pediatric lupus, kidney disease, women and men’s issues, medications and more. Our panel of nationally-renowned lupus medical experts provides insight, support and answers into the puzzling and often times frustrating issues of lupus. We invite you to submit your own questions through our website.

LFA Approved Publications
The Lupus Foundation of America Patient Education Committee has reviewed and approved a number publications and other materials for use in educating individuals and families about lupus and its health effects.

Symptoms of Lupus

Because lupus can affect so many different organs, a wide range of symptoms can occur. These symptoms may come and go, and different symptoms may appear at different times during the course of the disease.

The most common symptoms of lupus, which are the same for females and males, are:

• extreme fatigue (tiredness)
• headaches
• painful or swollen joints
• fever
• anemia (low numbers of red blood cells or hemoglobin, or low total blood volume)
• swelling (edema) in feet, legs, hands, and/or around eyes
• pain in chest on deep breathing (pleurisy)
• butterfly-shaped rash across cheeks and nose
• sun- or light-sensitivity (photosensitivity)
• hair loss
• abnormal blood clotting
• fingers turning white and/or blue when cold (Raynaud’s phenomenon)
• mouth or nose ulcers

Many of these symptoms occur in other illnesses besides lupus. In fact, lupus is sometimes called "the great imitator" because its symptoms are often like the symptoms of rheumatoid arthritis, blood disorders, fibromyalgia, diabetes, thyroid problems, Lyme disease, and a number of heart, lung, muscle, and bone diseases.

Forms of Lupus

Systemic Lupus Erythematosus

Systemic lupus is the most common form of lupus, and is what most people mean when they refer to "lupus." Systemic lupus can be mild or severe. Some of the more serious complications involving major organ systems are:

• inflammation of the kidneys (lupus nephritis), which can affect the body’s ability to filter waste from the blood and can be so damaging that dialysis or kidney transplant may be needed
• an increase in blood pressure in the lungs (pulmonary hypertension)
• inflammation of the nervous system and brain, which can cause memory problems, confusion, headaches, and strokes
• inflammation in the brain’s blood vessels, which can cause high fevers, seizures, behavioral changes,
• hardening of the arteries (coronary artery disease), which is a buildup of deposits on coronary artery walls that can lead to a heart attack

More information about how lupus affects various organs and tissues is available in the LFA fact sheet series, "The Body & Lupus."

Cutaneous Lupus Erythematosus

Cutaneous refers to the skin, and this form of lupus is limited to the skin. Although there are many types of rashes and lesions (sores) caused by cutaneous lupus, the most common rash is raised, scaly and red, but not itchy. It is commonly known as a discoid rash, because the areas of rash are shaped like disks, or circles. Another common example of cutaneous lupus is a rash over the cheeks and across the bridge of the nose, known as the butterfly rash. Other rashes or sores may appear on the face, neck, or scalp (areas of the skin that are exposed to sunlight or fluorescent light), or in the mouth, nose, or vagina. Hair loss and changes in the pigment, or color, of the skin are also symptoms of cutaneous lupus.

Approximately 10 percent of people who have cutaneous lupus will develop systemic lupus. However, it is likely that these people already had systemic lupus, with the skin rash as their main symptom.

Drug-induced Lupus Erythematosus

Drug-induced lupus is a lupus-like disease caused by certain prescription drugs. The symptoms of drug-induced lupus are similar to those of systemic lupus, but only rarely will any major organs be affected.

The drugs most commonly connected with drug-induced lupus are hydralazine (used to treat high blood pressure or hypertension), procainamide (used to treat irregular heart rhythms), and isoniazid (used to treat tuberculosis). Drug-induced lupus is more common in men because they are given these drugs more often; however, not everyone who takes these drugs will develop drug-induced lupus. The lupus-like symptoms usually disappear within six months after these medications are stopped.

Neonatal Lupus

Neonatal lupus is a rare condition that affects infants of women who have lupus and is caused by antibodies from the mother acting upon the infant in the womb. At birth, the infant may have a skin rash, liver problems, or low blood cell counts, but these symptoms disappear completely after several months with no lasting effects. Some infants with neonatal lupus can also have a serious heart defect. With proper testing, physicians can now identify most at-risk mothers, and the infant can be treated at or before birth. Most infants of mothers with lupus are entirely healthy.

What Causes Lupus?

Genes

No gene or group of genes has been proven to cause lupus. Lupus does, however, appear in certain families, and when one of two identical twins has lupus, there is an increased chance that the other twin will also develop the disease. These findings, as well as others, strongly suggest that genes are involved in the development of lupus. Although lupus can develop in people with no family history of lupus, there are likely to be other autoimmune diseases in some family members. Certain ethnic groups (people of African, Asian, Hispanic/Latino, Native American, Native Hawaiian, or Pacific Island descent) have a greater risk of developing lupus, which may be related to genes they have in common.

Environment

While a person’s genes may increase the chance that he or she will develop lupus, it takes some kind of environmental trigger to set off the illness or to bring on a flare. Examples include:

• ultraviolet rays from the sun
• ultraviolet rays from fluorescent light bulbs
• sulfa drugs, which make a person more sensitive to the sun, such as: Bactrim® and Septra® (trimethoprim-sulfamethoxazole); sulfisoxazole (Gantrisin®); tolbutamide (Orinase®); sulfasalazine (Azulfidine®); diuretics
• sun-sensitizing tetracycline drugs such as minocycline (Minocin®)
• penicillin or other antibiotic drugs such as: amoxicillin (Amoxil®); ampicillin (Ampicillin Sodium ADD-Vantage®); cloxacillin (Cloxapen®)
• an infection
• a cold or a viral illness
• exhaustion
• an injury
• emotional stress, such as a divorce, illness, death in the family, or other life complications
• anything that causes stress to the body, such as surgery, physical harm, pregnancy, or giving birth

Although many seemingly unrelated factors can trigger the onset of lupus in a susceptible person, scientists have noted some common features among many people who have lupus, including:

• exposure to the sun
• an infection
• being pregnant
• giving birth
• a drug taken to treat an illness

However, many people cannot remember or identify any specific factor that occurred before they were diagnosed with lupus.

Hormones

Hormones are the body’s messengers and they regulate many of the body’s functions. In particular, the sex hormone estrogen plays a role in lupus. Men and women both produce estrogen, but estrogen production is much greater in females. Many women have more lupus symptoms before menstrual periods and/or during pregnancy, when estrogen production is high. This may indicate that estrogen somehow regulates the severity of lupus. However, it does not mean that estrogen, or any other hormone for that matter, causes lupus.

What is Lupus?

Lupus is a chronic inflammatory disease that can affect various parts of the body, especially the skin, joints, blood, and kidneys.