Lupus treatment is personalized. If you have mild symptoms, your treatment will differ from others who experience moderate to severe lupus. Your doctor will assign treatments according to your symptoms and the systems and organs the lupus is affecting.
Because 20% to 30% of lupus cases are mild,1 they are managed with one or two uncomplicated medications. Getting enough sleep and exercising will reduce your fatigue, and that may also alleviate some of your joint pain.
However, if you are among the 70% to 80% of patients who live with moderate or severe lupus, your doctor will prescribe more aggressive treatments. If you have a lupus flare-up, you will also benefit from more aggressive treatments for a few weeks.
As your needs change, according to different stages in your life and in your lupus experience, your treatments will, too. Your doctor will adjust your treatments as your lupus changes.
For example, doctors frequently discontinue a medication after the disease enters a period of remission. So it is important to see your doctor frequently, allowing him or her to adjust your treatments according to your symptoms.
Lupus Treatments: The Medications
Hydroxychloroquine is a common lupus medication that reduces joint pain and helps prevent lupus flare-ups. It also reduces inflammation in the linings that protect your heart and lungs, and it relieves lupus-related fatigue and fever.
Non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen, celecoxib, diflunisal, and naproxen are very effective at treating pain, fevers, and inflammation from lupus. However, because of their side effects, some doctors encourage their patients to use NSAIDs mainly for lupus flares. Using NSAIDs over a long period of time can damage in your digestive system and kidneys.
NSAIDs can also cause headaches, skin rashes, and other symptoms that mimic lupus flares. This makes it harder for your doctor to know if you need more aggressive lupus treatment—or if you are just experiencing NSAID side effects.
If you have a flare-up, and hydroxychloroquine and NSAIDs are not providing enough relief, your doctor may choose to treat you with a steroid, which is an anti-inflammatory to help fight the infection.
Prednisone pills are the most common administration of a steroid. However, steroid injections and IVs can also be extremely effective.
Treating Lupus by Suppressing Your Immune System
When lupus threatens organs, doctors move aggressively to suppress your immune system. Because lupus is the result of your immune system malfunctioning, you can reduce the severity of lupus by suppressing your immune system.
The medications doctors prescribe to suppress your immunity include cyclosporine, cyclophosphamide, azathioprine, and mycophenolate.
While suppressing your immune system may dramatically reduce your lupus symptoms and reduce its damage, there are also many disadvantages to these medications. Suppressing your immune system increases your risk of infection. You will need to safeguard your personal hygiene and avoid sick people.
Medications that suppress your immune system have a long list of side effects including:
- bladder problems
- hair loss
- high blood pressure
These medications also interact with many other pharmaceuticals. If you live with other health conditions, you may have tough decisions to make about the tradeoff between treating lupus and the effect that the immune suppressors may have on your other conditions. Your doctor will help you make that decision.
Lupus Emergency: Watching for Flare-ups
You can prevent, or reduce the intensity, of a lupus emergency by learning to sense the onset of a lupus flare. The warning signs are:
- more fevers
- stomach aches
- aching muscles
If you sense a flare-up, start preventative treatment with your doctor.
Working with a Rheumatologist to Treat Lupus
Lupus treatment is complex, and you need to have a doctor who does it well, and who can get you in quickly. Early in the course of your illness, your primary care provider may be qualified to treat your lupus. He or she may continue to treat you as long as it remains mild.
However, if you develop moderate or severe lupus, you need the additional experience and focus of a rheumatologist to treat your lupus.