Lupus
How is it treated?
There is no cure for lupus, but individuals with the disease can find the best treatment and usually maintain their quality of life by working closely with their health care providers. Desired treatment goals include managing symptoms, inducing remission during times of disease flare, and maintaining remission for as long as possible.
Several types of drugs can be used to achieve treatment goals, but treatment must be individualized according to each person's particular symptoms. Finding the best treatment regimen tends to be a trial-and-error process because individuals respond differently to medications. It is therefore quite common for physicians to recommend one medication, monitor the relief it provides the patient and, if the desired result is not achieved, to change the dosage or prescribe another medication. Because some treatments may cause harmful side effects, it is important that individuals undergoing treatment for lupus promptly report new symptoms or side effects to their health care providers.
Drug therapy usually is targeted at reducing inflammation, the cause of most lupus symptoms. Drugs used to treat the disease include nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, disease modifying antirheumatic drugs (DMARDs), and cytotoxic drugs.
- NSAIDs: NSAIDs (either over-the-counter or prescription strength) are often recommended to alleviate fever, muscle pain, and joint pain and swelling. Individuals with a mild form of lupus may find an NSAID the only medication they need to relieve their symptoms, whereas individuals with more active or severe disease may require additional medications.
- Corticosteroids: Corticosteroids are the most common drugs used in lupus treatment because they reduce inflammation at a rapid speed and have been associated with a slowdown in the progression of the disease. The goal of corticosteroid therapy is to induce and maintain lupus remission using the lowest possible dose to avoid side effects, which can include fluid retention, muscle weakness, weight gain, increased blood sugar, and bone growth suppression (osteoporosis). Major organ involvement, however, may require higher doses of corticosteroids.
- DMARDs: DMARDs are frequently used in the treatment of lupus. They work by interfering with the immune system's function and are thought to protect against the damaging effects of ultraviolet light. DMARDs are effective in treating joint pain, skin rashes, fatigue, and inflammation of the lungs associated with lupus. Continuous use of DMARDs may prevent flares from recurring. In some cases, the use of DMARDs allows an individual to take lower doses of corticosteroids, decreasing the risk of side effects associated with high-dose corticosteroids.
- Cytotoxic drugs: Cytotoxic (cyto = cell; toxic = damage) drugs are usually prescribed for severe cases of lupus, when more than one major organ (kidneys, liver, brain, heart, lungs) is affected. These drugs work by targeting rapidly growing cells and therefore are useful in suppressing the cells involved in the hyperactive immune response.
Most individuals who have lupus are treated with NSAIDs, corticosteroids, and DMARDs, either alone or in combination.
To learn more about the drug classes used to treat lupus, click on the following links:
Drug classes used to treat Lupus Corticosteroids Cytotoxic Drugs Disease Modifying Antirheumatic Drugs Non-steroidal Anti-inflammatory Drugs
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