Once we are diagnosed, our doctor will develop a specific and unique treatment plan for each patient. This plan will be based on factors such as age, symptoms, general state of health, and lifestyle.
Since each lupus patient is different and lupus affects us differently, our doctor will give us the treatment he thinks is the most appropriate in our case. However, sometimes, we will have to try several treatments and combinations of them until we find the right treatment for our specific case.
In some cases, the first treatment they give us is indicated for our lupus, but in other cases, it can take months, and in some cases years, before our doctor, the right combination of medications to keep our lupus under control.
First of all, communication with the medical team during this process is important since we must be part of our treatment and follow-up. It will help us to have a better quality of life, more tranquility, and control.
The goal of lupus treatment:
Since lupus is a disease with no cure today, treatments will aim to keep lupus under control and minimize symptoms. These symptoms vary in intensity from one patient to another:
- Reduce the inflammation caused by lupus.
- Inhibit the hyperactivity of the immune system.
- Avoid relapses and treat them every time they occur.
- Control symptoms such as joint pain and fatigue.
- Avoid, prevent and minimize damage to organs,
Nonsteroidal anti-inflammatory drugs (NSAIDs) eliminate inflammation and are especially useful for joint pain and stiffness. However, NSAIDs can cause stomach irritation. You should be careful if you take any kind of NSAIDs since excessive amounts of them can reduce blood flow to the kidneys, which may interfere with their ability to eliminate waste from the body. This can translate into kidney problems, so many patients are advised against the use of NSAIDs. Consult with your specialist.
Prednisone is the steroid that is most commonly prescribed for lupus. Once the symptoms of lupus respond to treatment, the steroid dose is reduced (lowered) gradually and always by the specialist. Never stop taking this medicine or reduce your dose without first consulting it!
The most common side effects derived from steroids are some changes in physical appearance, such as the presence of acne, round or full moon-shaped face, weight gain due to increased appetite, hair growth, and bruising with some ease. Steroids can also cause irritability, agitation, nervousness, or depression. These changes in appearance and mood are most evident when high doses of steroids are given and can greatly affect the patient. It is in situations like this that patient associations can help a lot.
Antimalarial medications are used in combination with steroids and other medications in part to reduce the necessary dose of the other medications. Antimalarial drugs have some function as an anti-inflammatory, improve skin lesions, and also prevent relapses of lupus.
Unlike the rapid response obtained with steroids, antimalarial medications may take months before their effect is appreciated. Hydroxychloroquine (Dolquine, Plaquenil) and chloroquine (Aralen) are two types of antimalarial drugs used to treat lupus.
The side effects of antimalarial medications are rare and usually mild and include an upset stomach and changes in skin color. In cases of prolonged administration, antimalarial drugs can damage the retina of the eye, causing vision problems, so it is recommended that patients have a regular eye check.
Immunosuppressants (Immune modulators)
Immunosuppressants are used to control inflammation in the presence of an overactive immune system. However, these medications reduce the body’s ability to fight infections and increase the chances of getting infections.
Often, people with lupus need other medications to treat conditions that usually present with the disease: for example, antihypertensive medications for hypertension, antibiotics for infections, and bone-strengthening medications for osteoporosis.
Many medications are contraindicated if you are planning a pregnancy, are currently pregnant, or are breastfeeding. Ask your doctor when in doubt.