Definition
The lupus erythematosus outlines a systemic autoimmune pathology (also known as SLE) characterized by a tissue inflammation which, by auto-antibodies, spreads gradually throughout the body. Lupus erythematosus can involve the skin, kidneys, joints, brain, lungs, heart and blood cells.
Causes
Clinical evidence shows that Lupus erythematosus is strongly influenced by the genetic component; however, the disease can also be triggered by drugs (eg anticonvulsants, hydralazine, procainamide, etc.), viral infections (eg rubella) and, more rarely, by UV rays from the sun. The important estrogenic component of women can be a risk factor for the appearance of lupus.
Symptoms
The diagnosis of Lupus erythematosus is rather complex, since the onset symptoms often overlap with those of other less complex pathologies: asthenia, shortness of breath, joint and renal pain, fever, loss of appetite, skin lesions, malaise, dry eye, Raynaud's syndrome, oral ulcers. The most common symptom is a particular skin lesion on the face, shaped like a butterfly (involving the nose and cheeks).
Information on drugs to cure systemic lupus erythematosus is not intended to replace the direct relationship between health professional and patient. Always consult your doctor and / or specialist before taking Drugs to Treat Systemic Lupus Erythematosus.
drugs
There is no drug or cure that can permanently cure lupus erythematosus; rather, some treatments can help reduce the general symptoms - especially those related to neuropsychiatric manifestations, arthritis and nephropathy - thus improving the quality of life of the patient who is affected.
It is important to distinguish two general treatments: the first concerns the treatment of localized lupus erythematosus in some anatomical areas, the second that which also involves the deep organs (heart, kidneys, lungs).
NSAIDs : indicated for the treatment of mild to moderate lupus erythematosus, limited, therefore, to some anatomical sites; in particular, non-steroidal anti-inflammatory drugs are widely used when lupus erythematosus generates arthritis and arthralgias (pain in the joints and surrounding tissue)
- Acetylsalicylic acid (eg. Vivin, Ac Acet, Carin, Aspirin): the indicative dose for the treatment of symptoms of lupus erythematosus associated with arthritic pain is the following: 3 grams per day of drug, fractionated in several doses. The administration of the drug to children under the age of 12 can cause serious side effects, such as Reye's syndrome, liver dysfunction and brain alterations, therefore it is strongly advised against.
- Naproxen (eg. Naprosyn, Prexan, Naprius): used in therapy to treat the typical symptoms that accompany lupus erythematosus, especially fever, swelling and pain. Consult your doctor.
- Ibuprofen (eg. Brufen, 400 mg tablets; Subitene, 200 mg sachets; Moment, 200 mg tablets): useful for reducing fever caused by lupus erythematosus
Antimalarials : these drugs are used in the treatment of mild or moderate lupus erythematosus, especially when the disease mainly involves the skin and joints. Do not abuse these drugs: indiscriminate use can cause damage to the retina and stomach pains.
- Hydroxychloroquine (eg Plaquenil): indicated for the treatment of systemic and discoid lupus erythematosus; it is recommended to start therapy with a dose of 400 mg, to be taken orally 1-2 times a day for a few weeks or months, depending on the severity of the symptoms and the response to treatment. It is advisable, subsequently, to continue the therapy with a maintenance dose, ranging from 200 to 400 mg, to be taken by mouth once a day. It is recommended to always take the drug on a full stomach (or with a glass of milk).
- Chloroquine (eg Chloroquine, Cloroc FOS FN): this active ingredient is also used in therapy to treat systemic and discoid lupus erythematosus. Consult your doctor.
Steroids : to be taken exclusively after undertaking a NSAID based therapy, without satisfactory results. Indiscriminate or prolonged use of steroids can cause serious side effects (acne, weight gain, cataract, convulsions, glaucoma, osteoporosis, psychosis, peptic ulcer, etc.). For mild or moderate forms of lupus erythematosus, it is possible to undertake a therapeutic procedure based on steroids of rather short duration (in general, it is recommended to take a small dose of medication on alternate days, for a few months); for severe lupus erythematosus, therapy generally begins with a dose of steroid medication, continuing therapy with a progressive dose reduction.
- Prednisone (eg. Solprene, Deltamidrina): approximately, the recommended dose to lighten the symptoms of lupus erythematosus is 5 mg. This drug is certainly the corticosteroid most used in therapy to obtain a long-term suppressive therapeutic effect, very useful for treating systemic lupus erythematosus.
- Betamethasone (eg. Bentelan, Celestone, Diprosone): approximately, it is recommended to take a drug dose of 750 mcg (this dose is equivalent to 5 mg of prednisone).
- Methylprednisolone (eg. Medrol, Urbason, Solu-medrol): with the aim of decreasing the inflammation caused by lupus erythematosus; the daily dose of methylprednisolone can be around the gram, to be taken intravenously, for 3 consecutive days; the dose should be progressively reduced in the following days, taking at the same time drugs with different therapeutic action (eg cyclophosphamide: anticancer medicine - eg Endoxan Baxter - in boluses of 0.5-1.0 grams / m2, every 21-28 days, for 6 months).
- Triamcinolone (eg Kenacort): for the treatment of symptoms associated with systemic lupus erythematosus, it is recommended to start therapy with 20-32 mg of drug, to be taken orally for a period established by the doctor. Continue maintenance therapy, taking 48 mg orally per day.
Immunosuppressants : indicated for severe forms of lupus erythematosus. Immunosuppressive drugs are often used in combination with steroids, in order to decrease the doses of the latter, thereby reducing the side effects.
- Azathioprine (eg Azathioprine, Immunoprin, Azafor): the drug is indicated in case of nephritis due to lupus erythematosus. Take the drug at a dose of 1-3 mg / kg per day orally or intravenously, as directed by your doctor.
- Cyclophosphamide (eg Endoxan baxter, bottle or tablets): to be taken to treat the symptoms of lupus erythematosus in advanced form, with evident renal involvement. Prolonged intake of this drug can cause infertility in young women of child-bearing age (a target favored by the disease), as well as increasing the predisposition to leukemia, lymphomas and bladder tumors.
- Mycophenolate (eg Mycophenolate mofetil teva, Cellcept, Myclausen): the drug is indicated for the treatment of symptoms of lupus erythematosus with evident renal involvement.
- Belimumab (eg Benlysta): a last-generation immunosuppressant drug, particularly indicated for severe forms of systemic lupus erythematosus. It is recommended to take a dose of 10 mg / kg of an intravenous one hour infusion every 2 weeks for the first three doses; subsequently, continue with the same dosage at 4-week intervals.
Alternative therapy to treat lupus erythematosus
Plasma transfusion is an alternative therapeutic route for treating lupus erythematosus; although even this treatment is not completely conclusive, it seems to constitute a valid therapeutic option to alleviate the symptoms. Plasma transfusion has the objective of eliminating the antibody-antigen complexes that circulate there, so it is indicated to treat lupus erythematosus in those patients who do not respond to the treatments described above.
