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Department of Medicine

Department of Medicine

  Division of Rheumatology and Clinical Immunology

CENTERS AND INSTITUTES


Lupus


Lupus

TREATMENT

The medications listed are commonly used to treat lupus but should only be used under the supervision of an experienced rheumatologist or lupus specialist.

Some of the common medications used to treat lupus include:

  1. Non-steroidal anti-inflammatory medications (NSAIDs): Naproxen, ibuprofen or meloxicam can be used for treatment of rashes, joint pains They help most patients, but must be monitored for side effects.

  2. Prednisone (steroid/cortisone): One of the most commonly used medications for lupus, both to control (low dose) active disease and for disease "flares" (high dose).  Dermatologists may prescribe steroid creams or ointments for lupus rashes.

  3. Hydroxychloroquine (Plaquenil): This is a relatively safe and effective drug for lupus. Most physicians recommend long-term or life long treatment with to control symptoms and prevent disease "flares".

  4. Methotrexate (MTX): Often used in rheumatoid arthritis patients, this drug can help in the treatment of lupus arthritis and skin rashes.

  5. Azathioprine (Imuran): Useful for blood system involvement and kidney disease.

  6. Mycophenolate mofetil (Cellcept): Used primarily for kidney disease and for other more serious manifestations of lupus.

  7. Cyclosphosphamide (Cytoxan): Used primarily to treat central nervous system and kidney involvement and occasionally lung disease.

  8. High doses of intra-venous (IV or "pulse" corticosteroids): May be used monthly in severe 'flares'; typically given for 6 months and then converted to oral prednisone.

  9. Rituximab: Used 'off-label' for lupus kidney disease and brain disease and for other severe organ system involvement.

  10. Belimumab (Benlysta): Newest drug approved by the FDA for lupus, which should be used after other medications have been tried and failed to achieve benefit.

  11. Aspirin/Warfarin (Coumadin, blood thinners): Used in patients with a tendency for blood clots (anti-phospholipid antibody syndrome) to prevent strokes, leg vein and lung blood clots.

These are complex treatments, all of which require regular blood testing for disease monitoring to ensure their safety and efficacy for lupus patients. Lupus patients should be seen by a lupus expert or rheumatologist every 3-4 months to assess disease activity and to help control any ongoing symptoms and monitor for drug side-effects. Our hope is to achieve control of the disease (remission) with a goal of reducing disability and improving quality of life for lupus patients.

Other important components of lupus therapy include supportive care and counseling, treatment for depression and anxiety, use of sunscreens to protect against flares, treatment for associated fibromyalgia, and pain management.