Today, doctors have more choices to help patients manage lupus effectively, because the range and effectiveness of treatments have increased in recent decades. Current treatments and medications include:
Nonsteroidal anti-inflammatory drugs (NSAIDs), which decrease inflammation, are often used to treat people with joint or chest pain, fever and swelling. Some NSAIDs, like ibuprofen and naproxen, are available over the counter, others require a doctor’s prescription. They may be used alone or in combination with other types of drugs under a doctor’s direction.
While antimalarial drugs prevent and treat malaria, they’re also useful for lupus. A common antimalarial for lupus, hydroxychloroquine, may be used alone or in combination with other drugs to treat fatigue, joint pain, skin rashes, and lung inflammation. Clinical studies have found that regular use of antimalarials may prevent flares from recurring.
Corticosteroids are a family of drugs related to cortisol, a natural anti-inflammatory hormone. Rapidly suppressing inflammation, corticosteroids are potent drugs with side effects, so doctors will seek the lowest dose to achieve the desired benefit, or use them in combination with less potent drugs.
If your kidneys or central nervous system are affected by lupus, you may need immunosuppressive therapy, which restrains the overactive immune system by blocking the production of immune cells. The risk for side effects increases with the length of treatment.
In January 2021, the U.S. Food and Drug Administration approved the use of Aurinia Pharmaceuticals’ calcineurin inhibitor Lupkynis™ (voclosporin) in combination with standard immunosuppressive therapy to treat lupus nephritis in adults. Standard therapy refers to mycophenolate mofetil (MMF), and low dose steroids.
Calcineurin inhibitors inhibit or block an enzyme calcineurin that activates T-cells of the immune system. Because calcineurin inhibitors suppress the immune system they are known as immunosuppressants.
In 2011, the U.S. Food and Drug Administration (FDA) approved belimumab (Benlysta®), a B-lymphocyte stimulator (BLyS) protein inhibitor, for patients with lupus receiving other standard therapies. Given by IV infusion, belimumab may reduce the number of abnormal B cells thought to be a problem in lupus.
In July 2017, belimumab was approved by the FDA as a self-injectable (subcutaneous) formulation for people with systemic lupus erythematosus being treated with standard therapy. The new formulation allows patients to administer the drug to themselves as a once-weekly injection.
In December 2020, belimumab was approved by the FDA as a treatment for lupus nephritis in adults. One of the most common and serious complications of systemic lupus erythematosus, lupus nephritis refers to inflammation in the kidneys.
In addition to treatments for lupus itself, patients may also take additional medications to treat lupus-related problems, such as high cholesterol, high blood pressure, or infection.