R. Morgan Griffin
Brunilda Nazario, MD
Lupus -- also called systemic lupus erythematosus, or SLE -- might not have a cure, but it's a highly treatable condition. Lupus medications can help lower long-term risks and keep symptoms under control. According to the Lupus Foundation of America, 80% to 90% of people with lupus can expect a normal lifespan with good treatment.
Things used to be different. In the 1950s, most people with lupus died within a few years of diagnosis. What’s changed the prognosis? A combination of earlier diagnosis, better lupus medications, and more aggressive treatment, says Lisa Fitzgerald, MD, assistant professor of medicine at Harvard Medical School.
Now, the goal of lupus treatment is not just to reduce the symptoms, but to maintain full function, says Bonnie Lee Bermas, MD, director of the Brigham and Women's Hospital Lupus Center in Boston.
"I want people to have the same level of functioning that they had before they got sick," Bermas tells WebMD. "I want them to do all the things they used to do." With the right lupus medication and good care, many people can.
Lupus is mainly treated with medicine. The types of drugs that have been used to treat lupus include NSAIDs, corticosteroids and other immune system suppressing drugs, hydroxychloroquine, and the newest lupus drug, Benlysta.
Lupus medications work in different ways. What they have in common is that they all reduce swelling in the body, Fitzgerald says. Which drugs you need -- either alone or in combination -- depends on your particular case.
Keep in mind that it might take your rheumatologist some time to find the right lupus drug or combination. You may also need different medicines over time as your symptoms change.
"There is no one medication that helps all people with lupus," says Fitzgerald. "A drug might work well in some people and not at all in others. Unfortunately we don't have a way to predict who will benefit and who won't."
As many people with lupus know, the list of possible side effects from lupus medications can be alarming. However, Bermas says that fears about side effects can get blown out of proportion. Although lupus drugs can have serious side effects, many are quite rare and most can be well managed,she says.
"People need to realize that when they're taking these medications, we know what side effects to look for," says Fitzgerald. "If they occur, we change the medication and it usually goes away."
Talk to your rheumatologist about your concerns. He or she will help you weigh the potential risks and benefits of your lupus medication accurately.
Other than medicine, additional lupus treatments include:
Don't underestimate what you can do on your own for your lupus symptoms. Studies show that the condition can be improved by changes to your lifestyle.
Because lupus can cause so many different symptoms, it can be tough to manage. You'll need the help of a few doctors at least -- a GP, a rheumatologist, and other experts depending on your lupus symptoms.
Even with good treatment, your symptoms are likely to fluctuate over time. Lupus is always unpredictable. That's why careful monitoring and regular check-ups are so important. As long as you get help quickly, many serious complications can be delayed or prevented.
"I think people who have just been diagnosed with lupus should be optimistic about treatment," Bermas tells WebMD. It's true that there are no miracle cures. Finding the right approach might take trial and error. But with patience -- and the help of your health care team -- the odds are good that you'll find a lupus treatment plan that works.
SOURCES:Bonnie Lee Bermas, MD, director, Center for Lupus, Brigham and Women's Hospital, Boston.Lisa Fitzgerald, MD, rheumatologist, Lupus Center of Excellence at the Beth Israel Deaconess Medical Center, Boston.Dawn Isherwood, RN, House Educator, Lupus Foundation of America.Robert Katz, MD, associate professor of medicine, Rush Medical College, Chicago.Lupus Foundation of America.Department of Health and Human Services.Johns Hopkins Arthritis Center.AARP.
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