Systemic Lupus Erythematosis (S.L.E.)
Systemic lupus is a chronic inflammatory disease that can cause many different symptoms including pain and swelling of the joints, skin rashes and at times more serious internal organ disease. SLE is at times an elusive disease to diagnose. There are a number of laboratory tests which are very helpful in confirming the diagnosis, as well as monitoring treatment.
The American College of Rheumatology has established the following criteria which is listed for a diagnosis of lupus. This has been very helpful in clarifying an illness like lupus from other autoimmune diseases such as rheumatoid arthritis, Sjogren’s syndrome or vasculitis.
The treatment of lupus is dependent upon the specific clinical symptoms and laboratory tests that are present.
Some of the common medications used to treat lupus are listed below.
A. Nonsteroidal anti-inflammatory drugs (NSAIDs) such as Celebrex, Naprosyn and Mobic may help alleviate some of the muscle and joint pain.
B. Anti-malarial drugs. Medications such as hydroxychloroquine (Plaquenil) and chloroquine phosphate (Aralen) are the most commonly prescribed and may be very useful for not only muscle and joint pain but also skin rashes.
C. Corticosteroids. Prednisone is sometimes used for short periods of time as a bridge therapy when patients are having a flare.
The goal is often to avoid using prednisone for longer periods of time because of the potential side effects which might include cataracts, thin skin, thin bones (osteoporosis) and diabetes.
D. Immunosuppressives are often prescribed to patients with lupus who have internal organ involvement. This might include low dose weekly Methotrexate or Arava.
Lastly, Benlysta or Belimumab has recently been approved for the treatment of flares of lupus in patients who have been refractory to some of the stronger medications.
This new therapy is administered intravenously and has shown to be quite safe and effective in improving quality of life and allowing many patients who have been on prednisone for long periods of time to be able to safely reduce the dose of corticosteroids or discontinue them completely.