Systemic Lupus Erythematosus

Description

Alternative Names

Treatment

No treatment cures systemic lupus erythematosus, but many therapies can suppress symptoms and relieve discomfort. Treatment of SLE varies depending on the extent and severity of the disease.

No new drugs have been FDA approved for the treatment of SLE in over thirty years. Only three drugs are technically FDA-approved for the treatment of lupus today: prednisone, aspirin, and hydroxychloroquine, none of which are the standard of care. In everyday practice, numerous other, more effective agents are commonly used instead, based on empirical data and limited trial results. It is highly encouraging, however, that a new surge of interest has spurred numerous clinical studies and the development of many new therapeutic agents. Genetic research in lupus is progressing very rapidly, and several new drugs are likely to be approved in the near future.

Treating Mild Systemic Lupus Erythematosus

Less intensive treatments may be effective for symptoms of mild lupus. They include the following:

• Creams and sunblocks for rashes.
• Nonsteroidal anti-inflammatory drugs for fever, arthritis, and headache.
• Antimalarial agents are more intensive drugs but may be useful for pleurisy, mild kidney involvement, and inflammation of the tissue surrounding the heart.

Treating Severe Systemic Lupus Erythematosus

More aggressive treatment is needed if there is serious disease progression, evidenced by the following:

• Hemolytic anemia.
• Low platelet count with an accompanying rash (thrombocytopenia purpura).
• Major involvement in the lungs or heart.
• Significant kidney damage.
• Acute inflammation of the small blood vessels in the extremities or gastrointestinal tract.
• Severe central nervous system symptoms.

The primary approach to treating severe SLE is to suppress the immune factors, most often first with corticosteroids and other immunosuppressant agents. Investigative agents and procedures are also showing promise.

Treating Specific Complications

The major complications of the disease must be treated as separate problems, keeping in mind the specific aspects of SLE. They are discussed in another section.