The symptoms and severity of lupus can be very different from person to person. Since it is an autoimmune disorder, it may attack any combination of skin, joints, and organs. This means that the blend of medicines and lifestyle changes recommended for you may be quite different from someone else with lupus.
In general, the goal of any lupus treatment is to achieve remission or the lowest disease activity possible and improve the quality of life. Many medicines are available to prevent or slow organ damage and other symptoms of lupus.
Medications for lupus symptoms
Because lupus can attack any area of the body, there is a wide range of medicines that may be used to reduce flares, manage pain, and improve your quality of life. These drugs include:
- Antimalarial drugs to reduce flares
- Pain relievers (NSAIDs) to reduce pain
- Glucocorticoids (prednisone), a type of steroid used to control the disease when antimalarials and NSAIDs are not enough.
- Immunosuppressants are used in more severe lupus to prevent the body from attacking its own healthy cells.
- Belimumab (Benlysta), a biologic treatment, is a monoclonal antibody that decreases the activity of B cell lymphocytes. It is used in combination with other lupus treatments.
- Dehydroepiandrosterone (DHEA), a type of hormone that may be useful for people with hair loss, joint pain, fatigue, and brain fog.
- Blood pressure drugs are used to reduce blood pressure, a common side effect of the kidney damage caused by lupus.
- Statins lower cholesterol levels in the blood and help prevent cardiovascular damage.
- Anticonvulsants may be prescribed if seizures are caused by lupus attacks on the central nervous system.
- Antidepressants help improve and regulate mood if lupus or its complications are causing depression.
- Antipsychotics can help manage mental health disorders caused when lupus affects the brain.
- Antithrombotic agents (blood thinners) may be prescribed to reduce the chances of blood clots causing strokes, heart attacks, pulmonary edema, and other permanent damage.
- Bisphosphonates may be needed to help manage osteoporosis or weakening of the bones.1-3
Procedures to help manage lupus symptoms
Several surgeries or medical procedures may be needed if more severe symptoms of lupus develop, including:
- Plasmapheresis is a procedure where plasma (a part of the blood) is removed and replaced with healthy plasma.
- Surgery, such as kidney transplant or splenectomy (removal of the spleen), may be needed to manage certain conditions associated with lupus.
- Joint replacement may improve quality of life by increasing mobility and reducing the pain of damaged joints.
- Transfusions of blood or IV immunoglobulin may be needed in cases of severe hemolytic anemia, a common complication of lupus.1
Vaccines for people with lupus
People with lupus, especially those taking steroids and immunosuppressants, should get the flu, pneumonia, and Tdap (tetanus, diphtheria and pertussis) vaccines. That’s because respiratory infections can cause serious complications and even death in people with lupus. Talk to your doctor before getting any immunization since some vaccines are not recommended (live vaccines) or certain times you should not be immunized.4
Lifestyle changes to manage lupus
Lifestyle changes may be thought of as self-management of lupus. Depending on your symptoms, some combination of exercise, diet, stress reduction, and sun avoidance can ease your pain and fatigue, help your medicines work better, or reduce the need to take some drugs. People with lupus should not smoke, so it is important to stop smoking if you do.1
Complementary and alternative medicine for lupus
Several complementary and alternative medical treatments help some people with lupus manage pain and joint stiffness. These therapies include massage, acupuncture, herbal remedies, and arthritis jewelry and accessories. It is important to talk with your doctor before starting any type of treatment. While most therapies are safe, some can interact with other lupus medicines you may be taking.1