Although there’s no cure for lupus, there are ways to manage it and prevent complications. Hydroxychloroquine, an antimalarial drug, is usually the first-line treatment, but there are a variety of other treatment options, too.
Lupus is an autoimmune disease that causes an increase in inflammation that can affect multiple parts of the body. The most common form of lupus is called systemic lupus erythematosus.
The exact prevalence of lupus is unknown. However,
There’s currently no cure for lupus. However, there are treatments that can help manage it and reduce the risk of complications.
This article will take a closer look at the different treatments that are available for lupus and the potential future treatments that are in the pipeline.
What are the goals of lupus treatment?
Treatment for lupus has several important goals. Specifically, treatment aims to:
- improve lupus symptoms
- prevent lupus flares
- reduce damage to your organs and tissues
- minimize the level of immunosuppression associated with your lupus treatment
- boost your quality of life
Antimalarial drugs are the first-line treatment for lupus. These drugs are normally used to treat the parasitic disease malaria. However, they can also work to treat lupus.
The main type of antimalarial drug used for lupus is called hydroxychloroquine (Plaquenil). If you can’t take hydroxychloroquine for some reason, another antimalarial drug called chloroquine (Aralen) may be used instead.
- improve lupus skin symptoms
- reduce lupus flares
- prevent organ damage and complications, such as osteoporosis, blood clots, and heart or kidney disease
- improve survival
A complication of hydroxychloroquine is retinal damage, which can impact your vision. The risk of this increases with time. As such, it’s important that people with lupus see an eye doctor regularly to check for any vision changes.
In addition to antimalarial drugs, there are also several other treatments for lupus.
Corticosteroids are drugs that can be used to reduce immune system activity, lowering inflammation and pain. They may be given as a pill or an injection.
Generally speaking, corticosteroids are only used on a short-term basis to help manage lupus flares. After this, your doctor will taper you off of them. This is because they’re associated with a variety of side effects, including:
- weight gain
- trouble sleeping
- changes in mood
- an increased risk of other health problems, such as infections, osteoporosis, and diabetes
When lupus impacts the skin, corticosteroids may be given as a topical cream or gel.
Nonsteroidal anti-inflammatory drugs
Nonsteroidal anti-inflammatory drugs (NSAIDs) inhibit enzymes in the body that make molecules associated with pain and swelling.
Because of this, they can be used to alleviate these symptoms. In people with lupus, they can be useful for managing joint pain and swelling as well as other aches and pains.
One of the main side effects of NSAIDs is digestive upset. Additionally, using NSAIDs frequently can impact kidney function, so if you have lupus and kidney disease, it’s important to talk to your doctor before using NSAIDs.
Immunosuppressant drugs broadly lower the activity of the immune system. In people with autoimmune diseases like lupus they can help keep your immune system from attacking healthy tissues, causing symptoms and complications.
Some examples of immunosuppressive drugs that may be used for lupus include:
Because immunosuppressive drugs weaken your immune system, they can put you at an increased risk of developing potentially serious infections. Some, such as cyclophosphamide, can also raise your risk of developing cancer.
As such, immunosuppressive drugs are typically only used for more severe lupus when first-line treatment with hydroxychloroquine hasn’t been effective at managing symptoms.
Biologic drugs are drugs that come from a living source. For example, many biologic drugs are antibodies that have specific targets in the body. In this way, their activity is more focused than traditional immunosuppressant drugs.
Biologic drugs for lupus target specific proteins involved in the disease process. These biologic drugs include:
- anifrolumab (Saphnelo), which targets the type I interferon receptor that’s thought to be important for lupus
- belimumab (Benlysta), which targets a protein called B-lymphocyte stimulator and can reduce the activity of abnormal immune cells in lupus
It’s also possible that rituximab (Rituxan), which targets a protein on antibody-producing cells, may be prescribed off-label. Off-label means that it hasn’t been approved by the Food and Drug Administration (FDA) for the treatment of lupus.
Biologic drugs are typically prescribed when lupus is very severe and hasn’t responded to other treatments like hydroxychloroquine and immunosuppressant drugs.
What lifestyle changes can help with lupus?
In addition to taking your lupus medications as directed, there are also certain lifestyle changes that may help. These include:
- eating a balanced diet
- getting regular exercise
- finding effective ways to manage your stress levels
- getting enough sleep
- quitting smoking
- limiting the time you spend in the sun and protecting your skin when you’re outside
- engaging with a support network of trusted friends and family
- taking steps to prevent infections and getting any vaccines recommended by your doctor
- getting regular health checkups with your doctor
Researchers continue to investigate newer, more effective treatments for lupus. Potential treatments are evaluated in clinical trials.
Much of the focus of newer lupus treatments is on targeting specific aspects of the disease process. This typically involves the use of biologics and other types of targeted therapy drugs.
One example of such a drug is obinutuzumab (Gazyva), which is approved for the treatment of certain types of leukemia and lymphoma. Like rituximab, this drug targets antibody-producing cells.
The results of a recent clinical trial found that obinutuzumab was better than a placebo when added to corticosteroids and mycophenolate to treat lupus nephritis, which is when lupus attacks the kidneys.
Another drug type being investigated are JAK inhibitors, which inhibit inflammatory signaling in the body. An example is tofacitinib (Xeljanz), which is approved to treat rheumatoid arthritis, psoriatic arthritis, and ulcerative colitis.
Are there complementary and alternative therapies for lupus?
Complementary and alternative medicine (CAM) is when a nonstandard practice is used along with the standard medical treatment for a condition. Examples include therapies like acupuncture, herbal medicine, and homeopathy.
According to the
The Lupus Foundation of America notes that acupuncture may help with pain while meditation may aid in managing stress. However, they also say that some CAM practices like herbal medicine may interact harmfully with lupus medications.
As such, if you’re interested in CAM for lupus, always talk to your doctor before trying it. They can inform you of any potentially dangerous side effects.
While there’s no cure for lupus, there are ways to manage it. The goals of lupus treatment focus on reducing symptoms, preventing flares, and limiting damage to your body’s organs and tissues.
The first-line treatment for lupus is hydroxychloroquine. If lupus is more severe or this medication isn’t effective at managing symptoms, other drugs like immunosuppressants or biologics may be used.
It’s important to stick to your treatment plan to keep your lupus in check. If you have any questions about your treatment plan or are concerned that it’s not managing your symptoms, be sure to talk with your doctor about other treatments that may be right for you.