The Lupus Foundation of America estimates that 1.5 Americans have lupus, with approximately 5 million people worldwide also having a form of lupus. It is most common in women of childbearing age, but it does not discriminate – it can affect men, children, and teenagers as well.
A 2008 study published in Arthritis & Rheumatology indicated that the annual health care costs for a person with lupus was approximately $12,643 – add in the total cost of a loss of productivity (meaning a loss of work) for $8,659, and the annual total cost of lupus is approximately $20,924.
The bulk of that cost is the treatment. Unfortunately, lupus treatment is multifaceted, because lupus can target multiple organ systems.
Below, we’re going to investigate various treatment options for lupus – the traditional medical approach to treating lupus, alternative medical options, and natural treatment options.
Traditional Medical Lupus Treatment
By now, you likely understand that lupus is an autoimmune disease that is systemic; this means that it can affect the entire body. As such, treatment must be individualized because it must “fit” each person’s individual lupus symptoms and pathophysiology.
Here are the most common medications used to treat lupus:
- Antimalarial drugs: These drugs, which are most commonly used to treat malaria, affect the immune system and are known to reduce the amount of lupus exacerbations. An example of an antimalarial medication is hydroxychloroquine (Plaquenil). These medications can cause gastrointestinal upset, and rarely, retinal damage. As such, if prescribed, your physician will recommend regular eye exams.
- Corticosteroids: These drugs are known to reduce inflammation in general, and high doses can be used to treat inflammation of the kidneys and the brain. Examples of corticosteroids include prednisone and methylprednisolone (A-Methapred, Medrol). Despite their effectiveness at reducing inflammation, corticosteroids are fraught with side effects, including weight gain, elevated glucose levels, high blood pressure, thinning bones, and an increased risk of fracture. These risks are increased with long-term use.
- Immunosuppressants: In more serious cases of lupus, an immunosuppressant may prove beneficial. Examples of immunosuppressants include azathioprine (Imuran, Azasan), mycophenolate mofetil (CellCept) and methotrexate (Trexall).
- Biologics: Intravenous medications, this drug class can also help to reduce lupus symptoms. Examples include belimumab (Benlysta) and rituximab (Rituxan). Rituxan is typically reserved for more resistant cases of lupus. Symptoms of biologics include nausea, diarrhea, and infections. In rare cases, worsening depression can occur.
- Nonsteroidal anti-inflammatory drugs: For pain associated with lupus, NSAIDs that can be purchased over the counter are the drug of choice. NSAIDs can treat fevers, reduce inflammation, and can treat pain – a triple threat! Examples include ibuprofen (Advil, Motrin IB) and naproxen (Aleve). For resistant symptoms, stronger NSAIDs can be prescribed. NSAIDs have been associated with gastrointestinal bleeding, an increased risk of heart problems, and an increased risk for kidney problems.
All of the above medications are FDA-approved medications for the treatment of lupus. Occasionally, a medication is used “off-label”, which means that it is used without FDA-approval because the pros outweigh the cons and it is still thought to be effective. An example is the use of DHEA (dehydroepiandrosterone) to treat lupus.
DHEA is a mild male hormone that has been found to be effective to treat mild to moderate lupus – specifically lupus symptoms that include hair loss, fatigue, cognitive dysfunction, joint pain, and fatigue. It has the added bonus of preventing osteoporosis. Because it is a hormone, it does have side effects, which include acne, oily skin, facial hair growth, and excessive sweating.
DHEA is also contraindicated in certain patient populations: men, women who are pregnant, trying to become pregnant, or who are breastfeeding, and those with a cancer that may be influenced by hormones. Post-menopausal women who are prescribed DHEA should be monitored.
Although these are the common medications to treat lupus, your physician may use other medications to treat your condition. As we’ve discussed, lupus can affect different body systems, therefore your treatment plan may require a varied medication profile.
For example, if lupus has affected your blood pressure due to weight gain and/or long-term steroid use, your physician will likely prescribe an antihypertensive medication to reduce your blood pressure.
Next page: alternative lupus treatment and natural lupus treatment options.