How Lupus Is Treated
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Drug Induced Lupus
|What Is The Treatment For Lupus?
There is no cure for lupus but there are treatments that can reduce or even eliminate side effects. The goals of treatment are to:
Drugs are the main treatment for people with lupus. Which drugs you are prescribed will change often during your treatment. Symptoms can come and go and new symptoms can appear years after the original diagnosis. Medications include:-
Painkillers: Nonsteroidal anti-inflammatory drugs (NSAIDs)
Corticosteroids: Also called steroids, corticosteroids are used to reduce inflammation in many parts of the body. In high doses they can calm the immune system. These medications are not the same as those taken by sports people who want to build muscle. Prednisone is the most common steroid prescribed for lupus. Symptoms of lupus usually respond quickly to this powerful drug. Once they subside the dose should be lowered until you no longer need it. The dose should be gradually reduced because stopping it suddenly can harm the body. Corticosteroids can have some unpleasant short-term side effects such as acne, puffy face, increased appetite, weight gain, mood swings and heartburn. Most of these side effects disappear once the medication is stopped. However weight gain will require dieting to lose again (to avoid the problem patients are advised to resist overeating when taking the meds). Long-term side effects include thinning skin and hair loss, easy bruising, osteoporosis, hypertension, high blood sugar and cataracts. Some people suffer depression, ulcers and congestive heart failure. Other medications may be prescribed with steroids to help prevent some of the worst side effects.
Anti-Malaria Drugs: It may sound strange, but most patients with lupus are prescribed anti-malaria drugs (antimalarials). The 2 most common antimalarials taken for lupus are Plaquenil and Aralen. Studies show that taken regularly as therapy (even in asymptomatic patients) antimalarials may prevent long-term organ damage and stop flares. Those taking antimalarials need to have their eyes checked once a year because of a low risk of eye problems. Other possible side effects include headaches, blurred vision, itching, trouble sleeping, diarrhea and nausea.
Chemotherapy drugs: These are only given to patients with severe lupus when other medications have failed to work. They suppress the immune system to limit damage to organs. Examples include Imuran, Rheumatrex, Trexall, Cytoxan and Cellcept. Chemo medications can cause serious side effects such as hair loss, vomiting, bladder problems, reduced fertility and the risk of infection and cancer. If you are taking these medications you will need to avoid pregnancy because of the risk of birth defects.
Other medications: Lupus patients may also need other medication to treat conditions linked to lupus. These include blood pressure drugs, osteoporosis medications and anticoagulants (blood thinners) like warfarin or heparin to reduce the risk of blood clots. Blood clots can lead to heart attacks, strokes and pulmonary embolus (lung clot).
Benlysta: This is a new type of drug approved by the FDA to limit the amount of autoantibodies in people with lupus. Two large studies showed it was both effective and safe. However other research reported more deaths and serious infections in patients taking the drugs. Research is ongoing.
About 75 percent of people with lupus develop some kind of skin disease. It may be rashes or sores (lesions) which appear on areas exposed to the sun such as the face, ears, neck, legs and arms. They rarely scar but they can change the color of the skin permanently. Traditionally rashes were treated with topical corticosteroid creams or ointments. Protopic and Elidel are two new products which have been show to minimize the effects of the immune system in the skin, including the butterfly rash, subacute cutaneous lupus and possibly lesions. These creams do not have the same side effects as corticosteroid creams.
Regular exercise, especially when combined with sufficient rest, may help combat fatigue associated with lupus.
Most people start by seeing their family doctor who then refers them to a rheumatologist. A rheumatologist is a doctor who specializes in diseases of the muscles and joints. Depending on how the disease progresses, you may also be referred to a:
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