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How it is Treated

Treatment aims to suppress the overactive immune system and diminish inflammation. Treatment may be aggressive (e.g. steroids), but milder drugs are also widely used (e.g. antimalarials). With time the aim is to reduce drugs and ultimately discontinue their use. Patients may experience a fluctuating course of lupus, but most patients do get better and in the long term and aggressive treatment may not be needed.

Generally drugs used in the treatment of lupus fall into 4 groups:

  1. Aspirin and Non Steroidals - low dose aspirin (75mg per day) "junior aspirin" is widely used in those patients with Antiphospholipid syndrome or "sticky blood". Non-steroidal anti-inflammatory drugs are also useful for joint and muscle pains but should be used sparingly because of their side effects on the stomach.

  2. Anti-malarials - Hydroxychloroquine is a mainstay of treatment for mild to moderate lupus. It has an anti-inflammatory effect as well as providing some protection against sunlight and is often used as the first line of treatment.

  3. Steroids - are vital and even life saving in acute flares but modern treatment aims at reducing or even stopping steroid treatment wherever possible.

  4. Immuno suppressives - in lupus the immune system is overactive hence the development of a number of drugs used to suppress the overactive immune response. These include Azathioprine, Methotrexate, Mycophenolate and Mofetil (MMF) as well as the stronger cyclo-phosphamide. The latter drug is reserved for patients with severe disease and is usually administered by injection.