Day 5: How is Lupus Treated?

5 May 2016:

There is no cure for Lupus. However, some drugs can be used to combat the symptoms.

In 1951, an article in The Lancet described the successful use of hydroxychloroquine, an anti-malarial, to treat Lupus. Since then, hydroxychloroquine has been the main first-level treatment for Lupus. There is substantial medical evidence that early treatment with hydroxychloroquine significantly delays Lupus from attacking major organs, like the kidneys, heart, and lungs. Furthermore, hydroxychloroquine has almost no side effects, so it provides a fairly good quality of life.

Often, people with Lupus are also treated with non-steroid anti-inflammatory drugs (NSAIDs), like Naproxen, Indomethacyn, Meloxicam, and others. These especially help with pain associated with inflammation in the joints, muscles, and nervous system.

When these together become ineffective, the next level of treatment for Lupus involves either corticosteroids or immunosuppressants, or some combination of those. Because the immune system causes the inflammation in Lupus, the best way to treat it is often by suppressing the immune system. It is not uncommon for people with Lupus to be placed on short courses of chemo therapy.

When the kidneys are involved, Lupus patients often must have dialysis. Since I was diagnosed 4 years ago, I have been on hydroxychloroquine and several different forms of NSAIDs. I have occasionally been treated with steroids. However, now that we know my lungs are involved, these drugs alone are clearly not enough. I am currently waiting to see the specialist, to know where we will be going from here.

In recent years, there are new types of drugs, usually ending in ‘imab’, that have the ability to suppress very specific parts of the immune system by turning off specific cells, often T-cells, but others as well depending on the drug. These come from research done with stem cells. Right now, these drugs are only given to Lupus patients with very severe disease activity, and only if they fit specific guidelines, such as having kidney failure. As research continues, perhaps these drugs will become more broadly useful, and be applied to the more general auto-immune suffering community.

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