There is no cure for lupus. Treatment involves managing symptoms with a combination of medications and lifestyle changes.
Regular doctor's visits and laboratory tests are needed to determine how well treatment is working and to monitor any potential side effects. More frequent office visits and monitoring may be needed at first, or if disease activity remains high. Treatment for mild lupus might require monitoring every 6 to 12 months.
There following medications are used to prevent lupus flares and treat symptoms.
- Nonsteroidal anti-inflammatory drugs (NSAIDs). Many people with lupus take NSAIDs to manage joint pain and swelling. NSAIDs such as aspirin, naproxen and ibuprofen can be purchased over the counter, but a prescription is needed for stronger ones.
- Corticosteroids. Corticosteroids, such as prednisone, can be helpful in reducing inflammation. Sometimes steroids are used for a few weeks until other slower medications can become effective. Because of their many side effects, the lowest possible dose should be used for the shortest length of time. Usually a corticosteroid is given by mouth as a pill or liquid. However, some forms can be given as an injection into the joint or muscle, or as an IV into a vein. It is important to slowly stop (taper off) steroids instead of stopping them suddenly.
- Disease-modifying antirheumatic drugs (DMARDs). DMARDs do more than just treat the symptoms of lupus. Research has shown that they can modify the course of the disease, prevent progression and slow joint damage. DMARDs are often used with NSAIDs. Hydroxychloriquine commonly is prescribed for people with lupus. It can cause vision changes in some people, so it is important to have regular vision examinations. Hydroxychloriquine is effective in preventing flares.
- BLyS-specific inhibitors. Belimumab is one such drug. It was approved in 2011 as the first drug specifically for the treatment of lupus in 50 years. It suppresses autoantibodies in people with lupus. Although it has been shown to help some people with lupus, further research is needed to determine its long-term efficacy and safety.
- Immunosuppressive agents/chemotherapy. In advanced cases of lupus, drugs like azathioprine, methotrexate and cyclophosphamide might be used to suppress the immune system. These types of therapies can help prevent organ damage; however, they do cause severe side effects as well as infertility in women. People on immunosuppressive therapies must be closely monitored by a doctor.
Diet and physical activity are also an important part of treatment. A balanced diet should be made up of fruits, vegetables and whole grains, as well as low-fat dairy and lean sources of protein. Look for foods high in omega-3s, which have been should to reduce inflammation.
Rest and physical activity are also important. When disease is active and joints are painful, swollen or stiff, it is important to rest to reduce inflammation and fatigue. When disease activity is low, however, it is very important to get regular exercise, which includes low-impact aerobic activity, muscle strengthening and flexibility exercises.