Lupus Treatments: What Your Rheumatologist May Consider
There is no cure yet, but from hydroxychloroquine to newer biologics like Benlysta and Saphnelo, treatment lets most people live productive lives.
There is no current cure for lupus, but there are treatment options that help individuals live productive lives. Because lupus can affect multiple organ systems, specialists such as a nephrologist, cardiologist, ophthalmologist, gastroenterologist, hematologist, or OB/GYN may join the medical team. The goals of treatment are to manage symptoms, prevent long-term organ damage, and prevent flares.
Any plan begins with a discussion of the benefits and risks of each medication and a review of your medical history with your rheumatologist. Common options include nonsteroidal anti-inflammatory drugs (NSAIDs), antimalarial drugs such as hydroxychloroquine, and steroids like prednisone, methylprednisolone, and prednisolone.
Immunosuppressants may include azathioprine (Imuran), methotrexate (for predominant joint symptoms), cyclophosphamide (Cytoxan, a lower-dose form of chemotherapy to control inflammation), cyclosporine (Neoral), and mycophenolate mofetil (CellCept).
Newer biologics, given as injections or infusions, block specific chemicals that drive inflammation and the overactive immune response. These include belimumab (Benlysta), FDA-approved for active but not severe adult lupus; rituximab (Rituxan), which can treat cell-count abnormalities; and anifrolumab (Saphnelo), for adults with moderate to severe lupus. Many more medications are being investigated in clinical trials.
Although I have seen the difficult side of this disease, I have witnessed many success stories. Most people can live normal, productive lives, but lupus is chronic and can be challenging during flares. Take an active role in your treatment plan and find support with family, friends, health professionals, and others living with the disease. Helpful resources include the American College of Rheumatology (rheumatology.org), the Lupus Foundation of America (lupus.org), the Lupus Research Alliance (lupusresearch.org), and Lupus LA (lupusla.org). There is so much hope for a future cure.
Dr. Maggie Cadet, MD