Lupus: Treatments

The main aim of treatment for systemic lupus erythematosus is to reduce inflammation. It should be based on how much the patient has been affected, as the illness varies from patient to patient.

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In the treatment of lupus, the first-line is NSAIDS (non-steroidal anti-inflammatory drugs) to alleviate the pain.
These NSAIDS may not be enough, however. It may also be necessary for lupus patients to receive anti-inflammatory steroids (also known as corticosteroids) such as prednisone. They are administered as part of an effective, minimal dosage treatment regimen, because these medications are not without their own side effects.

If the corticosteroids are not sufficient, the doctor may prescribe immunosuppressants such as cyclophosphamide, azathioprine or mycophenolate mofetil.

Hydroxychloroquine, a synthetic antimalarial drug, also forms a basic treatment for lupus due to its effect in preventing relapses. However, it may take several weeks before the effect can be felt.

Another medication, belimumab, has recently been approved in the United States. It is not currently available on the market in France, however. 

Another medication used is thalidomide, a heavily debated but highly effective treatment for lupus. This molecule is prescribed in a specific context: birth control pills must be taken, because thalidomide has teratogenic effects on the fetus (physical deformities).

Ultimately, in addition to treating lupus, it is necessary to treat these complications using anticoagulants in the event of blood clots, as well as anti-hypertensives. These treatments are decided upon by the doctor on a case-by-case basis.

LUPUS MONITORING

Patient monitoring is essential in lupus erythematosus. The appearance of any potential new harm suffered should be monitored in order to make sure that there is an absence of major side effects.

For this reason, a clinical examination is advised, as is a protein test (albumin) in the urine every three to six months, or every month in the event of progressive lupus. In the same way, blood tests are performed at each visit in order to determine the progression of the condition and to verify the absence of renal or cardiovascular damage.

In the case of treatment with hydroxychloroquine, ophthalmology follow-ups will also be needed due to possible retinal damage resulting from lupus.

Last updated: 5/11/19

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