The Treatment for Systematic Lupus Erythematosus (SLE)

The treatment for Systematic Lupus Erythematosus is based on alleviating the symptoms by adapting to each person. There is an abundance of effective medications for each patient's clinical situation.

Reviewed and approved by the pharmacist María Vijande.

Written by María Vijande

Last update: 11 June, 2022

The treatment for Systematic Lupus Erythematosus is symptomatic. Because of this, there is no definitive etiological treatment that can cure this illness. However, there are numerous treatments that focus on relieving the symptoms.

No matter what, doctors must adapt treatment to each patient’s specific situation. In addition, the patient must consent to it while keeping in mind all of the benefits and risks.

Today, we’ll take a look at this process.

Treatment of Lupus

First of all, let’s take a look at the most common treatment for Systematic Lupus Erythematosus:

• Non-steroidal anti-inflammatory drugs (NSAIDs)
• Glucocorticoids
• Antimalarials
• Immunosuppressants
• Biological therapies

NSAIDs

NSAIDs, like ibuprofen or paracetamol, are the drugs of choice for the symptomatic treatment of the musculoskeletal manifestations. They’re usually recommended for limited periods of time to lower the chances of risk when taking them.

When these medications are prescribed, you must keep in mind the negative side effects they may have on your digestion, renal, and cardiovascular systems. You should avoid using them if you have or develop a renal affectation. 

Glucocorticoids

This group of medications has been the basis of treatment for SLE due to its anti-inflammatory and immunosuppressant abilities. Thus, it continues to be the most important and most effective treatment when it comes to the acute phases of this illness.

Unfortunately, you cannot take these drugs for an extended period of time. This is because they can become toxic and can cause an adverse effect, including other conditions:

• Osteoporosis
• Cushing Syndrome
• Mellitus Diabetes
• An increase in the risk of infections
• Glaucoma

For these cases, doctors recommend taking a dosage of less than or equal to 5 mg/day of prednisone (or an equivalent) and to stop the treatment as soon as possible. 

Despite its high level of toxicity, practically all of the complications that come by this illness can be treated successfully with corticoids. 

Antimalarials

Chloroquine stands out among this group, especially hydroxy-chloroquine. Overall, they’re the medications of choice for the majority of patients with SLE. In addition, they’re the only drugs specifically indicated for SLE (until the approval of belimumab, which we’ll talk about later).

These medications are mainly helpful to fight:

• Arthritis
• Fatigue
• Some skin injuries
• Pericarditis
• General symptoms

Patients often tolerate antimalarials well, and their main drawback is the possibility of toxicity in the retina. Because of this, doctors recommend that patients get periodic ophthalmologist exams.

In addition, doctors can even prescribe these drugs during the gestation period because they help to regulate cholesterol levels. Plus, they have a beneficial anti-aggregative action for these patients.

Immunosuppressants

Lupus treatment with immunosuppressants is reserved for patients who do not respond correctly to the antimalarial and glucocorticoid treatments. 

Overall, the most commonly used immunosuppressants to fight this illness are:

• Cyclophosphamide
• Mycophenolate mofetil
• Azathioprine
• Methotrexate

Biological Therapy

This type of therapy is fairly new, so many clinical trials are still studying it. This therapy uses biological medication or monoclonal antibodies. The most common types are Belimumab and Rituximab.

If the symptoms have not improved after 6 months for patients using this therapy, they should think about discontinuing this treatment. Both of these medications are currently being tested.

To learn more about this illness, check out our article dedicated to it: