Lupus Treatment

There is currently no cure for systemic lupus erythematosus (SLE). However, there are treatments which can help to ease and manage your symptoms, minimising the effect that the condition has on your daily life.

Medication

If you only have very mild symptoms of SLE, you may not require any specific treatment. However, most people will require some sort of medication to help them to manage their symptoms.

Some of the medicines that you may require if you have SLE are outlined below.

Non-steroidal anti-inflammatory drugs (NSAIDs)

Non-steroidal anti-inflammatory drugs (NSAIDs) are a form of painkilling medication that work by reducing inflammation in the body.

If you are experiencing joint or muscle pain as a result of SLE, you may be prescribed an NSAID to help ease your symptoms.

Commonly prescribed NSAIDs for SLE include:

  • Ibuprofen.
  • Naproxen.
  • Diclofenac.
  • Piroxican.

You can buy some NSAIDs, such as ibuprofen, over-the-counter (OTC). OTC NSAIDs may be suitable if your joint or muscle pain is mild. If your pain is more severe, you will need stronger medication, which will have to be prescribed by your GP.

NSAIDs may not be suitable for people who have, or have had in the past, stomach, kidney or liver problems. They may also be unsuitable for people with asthma. Children under 16 years of age should not be given aspirin. Your GP will be able to advise you about which NSAID will be most suitable for you.

If taken in high doses, or over long periods of time, NSAIDs can damage your stomach lining, which may cause internal bleeding. If you need to take NSAIDs on a long-term basis, your GP will carefully monitor your condition in order to ensure that the medication is not causing you stomach bleeding. However, if this occurs, an alternative medicine can usually be prescribed.

Hydroxychloroquine

Hydroxychloroquine is a type of medicine that is normally used to treat malaria. However, it is also effective in treating some of the symptoms of SLE, such as skin rashes, joint and muscle pain, and fatigue.

You will normally have to take hydroxychloroquine for between 6-12 weeks in order for it to be fully effective. Once your symptoms are being more adequately managed, your dosage can usually be reduced.

Many people with SLE take hydroxychloroquine on a long-term basis as a way of controlling their symptoms and helping to prevent ‘flare-ups’.

Side effects of hydroxychloroquine are relatively rare but may include:

  • Indigestion.
  • Diarrhoea.
  • Headaches.
  • Skin rashes.

Hydroxychloroquine has also been known to cause more serious side effects in a small number of people. Approximately 1 in 2,000 people taking this medicine may experience damage to their vision.

You should therefore contact your GP as soon as possible if you experience problems with your vision and you are taking hydroxychloroquine. If your GP feels that it is necessary, you may also need to have regular eye examinations in order to help reduce your risk of developing complications.

Corticosteroids

Corticosteroids are a type of medicine that helps to quickly reduce inflammation. They are normally only prescribed if you have severe SLE.

If your SLE symptoms are severe, or you are experiencing a flare-up, you may be given a large dose of corticosteroids in order to help bring your symptoms under control. As your symptoms ease, your dosage can gradually be reduced.

When prescribing corticosteroids, the lowest effective dosage is always given. This is because high doses of corticosteroids, or long-term use of the medication, can cause side effects. These may include:

  • Thinning of your bones.
  • Thinning of your skin.
  • Weight gain.
  • Muscle wasting.
  • High blood pressure (hypertension).

If taken correctly, and under the careful supervision of your GP, corticosteroids are a safe and effective form of treatment.

Corticosteroids are not the same as anabolic steroids, which are sometimes used by athletes and bodybuilders to improve performance.

Immunosuppressants

Immunosuppressants are a type of medicine that work by suppressing your immune system. They can help to improve your SLE symptoms by limiting the damage that your immune system causes when it attacks the healthy parts of your body.

Commonly prescribed immunosuppressant medicines include:

  • Azothioprine.
  • Methotrexate.
  • Cyclophosphamide.

Immunosuppressants are sometimes used in conjunction with corticosteroids (see above) as these medicines may ease your symptoms more effectively when used together.

Immunosuppressant medication is normally only prescribed if you have severe SLE. This is because this type of medication is very powerful and can cause serious side effects.

Suppressing your immune system increases your risk of developing infections. Immunosuppressants can also sometimes cause damage to your liver. For these reasons, you will need to undergo regular check-ups when taking immunosuppressant medication in order to help to reduce the risk of complications.

Protecting yourself from the sun

Exposure to sunlight can sometimes make SLE symptoms, such as skin rashes, worse. Therefore, it is very important to make sure that you protect your skin when you are out in the sun.

This means wearing clothing which cover your skin, as well as wearing a wide-brimmed hat and sunglasses. You also need to apply a high factor sun screen when you are out in the sun, as this will help to reduce your risk of having a flare-up of symptoms.

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