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A New Free Report - What Is Lupus?
This fascinating new report from UK-based publishing house Health Research Today answers some of the most-asked questions about this baffling disease :
- What is the medical definition of lupus?
- What are the symptoms of lupus?
- What tests are there for lupus? How do you get a diagnosis?
Fill in this form and we will send you the report immediately, which you are welcome to send on to friends or family!
Medical Treatments for Lupus
This article is an extract from the ebook Freedom From Lupus!
Steroids
Tissue inflammation is the major cause of lupus symptoms. While the body naturally produces cortisone to decrease inflammation, it may not be solely effective in reducing the inflammation in lupus patients. Therefore, synthetic steroids are used to decrease the swelling, warmth, tenderness, and pain in lupus patients.
Corticosteroids are a commonly prescribed medication. Corticosteroids are produced by the outer part of the adrenal gland, and they differ from the anabolic steroids that weightlifters use illegally to increase their strength and size. The most commonly used corticosteroid is Prednisone, while others used include hydrocortisone, methylprednisolone (Medrol), and dexamethasone (Decadron). They usually relieve symptoms right away. Corticosteroids can be helpful in serious cases of inflammation like pleurisy, pericarditis, or organ threatening disease, but they do have some serious side effects.
While steroids are remarkably effective at decreasing lupus symptoms, they come with numerous side effects. Common side effects include acne, the development of a moon-shaped face, and increased appetite. The increase in appetite can also cause weight gain. They can redistribute fat and lead to more fragile skin. The psychological effects of steroids include irritability, agitation, euphoria, and depression. Also, insomnia can set in. There is a higher susceptibility of getting an infection and the possibility of aggravating any diabetes, glaucoma, high blood pressure, and high cholesterol. However, it should be noted that steroids do not cause cancer.
Long-term use of steroids can result in some serious conditions. Avascular necrosis of the bone is usually associated with high doses of prednisone taken over a long time period. The disease usually occurs in the hip, and it is very painful. Relief usually comes in the form of a core bone biopsy or joint replacement. Osteoporosis is another common result of long-term steroid use, but it can usually be prevented with calcium, vitamin D, hormones, calcitonin, biphosphonates, and certain hormones.
Cataracts, and muscle weakness are also caused by long-term use. Plus, there is a relationship between premature arteriosclerosis and long-term steroid use. It is due to these potential side effects that steroids need to be used with great care and under a physician’s watchful eye.
Immunosuppressives
The fourth class of drugs used to treat lupus are known as Immunosuppressives. As the name implies, Immunosuppressives are used to suppress or inhibit an over-active immune system.
Immunosuppressives are normally used in transplant patients to prevent the body from rejecting the transplanted organ. Immunosuppressives are often used in patients with more serious systemic lupus. Doctors consider using immunosuppressives when major organs like the kidneys are affected, severe muscle inflammation is present, or there is intractable arthritis. Immunosuppressives can also be helpful in decreasing the amount of steroids needed to treat inflammation, saving patients who are susceptible to more severe side effects from added discomfort.
There are several immunosuppressives available in the treatment of lupus, though five are the most commonly used: azanthioprine (Imuran®), cycolphosphamide (Cytoxan®), methotrexate (Rheumatrex®), cyclosporine (Neoral®), and mycophenolate mofetil (CellCept®). They each work in different ways, but all immunosuppressives function to decrease or prevent an immune response.
Azanthioprine (Imuran):
For lupus patients, azathioprine is one of the most often prescribed immunosuppressives. It is also an antimetabolite, meaning it blocks metabolic steps in immune cell, thus helping to control the underlying processes in a disease. It also has fewer side effects than other lupus drugs.
Cyclophosphamide (Cytoxan):
Cyclophosphamide is an alkylating agent and a very strong drug. It is usually only used in lupus patients that have kidney or other organ threatening disease. Cycolphosphamide goes after autoantibody producing cells. This activity suppresses the immune response and decreases disease activity. However, its use can produce severe side effects.
Methotrexate (Rheumatrex):
Methotrexate was first used as a treatment for cancer and then used to treat rheumatoid arthritis. It is also an antimetabolite and often used for lupus arthritis. There is some concern about toxicity, so doctors will have to do regular CBC and liver function tests.
Cyclosporine (Neoral):
Cyclosporine is commonly used to threat rheumatic diseases, and it is an antimetabolite.
Mycophenolate mofetil (CellCept):
Mycophenolate mofetil is a strong immunosuppressive and is sometimes used in place of cyclophosphamide in patients that have kidney involvement. It functions by preventing the replication of T and B-lymphocytes.
Some of the side effects associated with immunosuppressives include an increased risk of infection and bone marrow suppression. Also malignancies can develop from their use. Some patients experience alopecia, nausea, vomiting, esophagitis, hematuria, thrombocytopenia, and leukopenia. With high doses, pulmonary fibrosis can develop. Side effects like amenorrhea and impotence reverse themselves with the discontinuation of the medication.
DHEA
DHEA is one of the new hopes in medicinal treatment of lupus symptoms, but it comes with cautious optimism. DHEA (dehydroepiandrosterone) is a steroid hormone that occurs naturally in all mammals. It is an androgen produced by the adrenal glands, and is used to make other hormones like testosterone and estrogen.
DHEA has not been without its controversy. In 1980 the supplement was banned by the FDA after the FDA declared DHEA was a drug (by declaring it a drug the law required it be tested for safety and efficacy by the FDA). However, Canada and the U.K. have banned over-the-counter sales of DHEA altogether.
Basically DHEA is used in lupus patients to decrease dosages of steroids, because it helps to relieve pain, inflammation, and fatigue. Much of the documented research has been done by Genelabs with most of the participants reporting that they felt better.12 While the researchers do not know the mechanism by which DHEA affects lupus, they do know that women with lupus have lower DHEA levels. They also know that DHEA increases testosterone and estrogen levels.
The side effects of DHEA have not been fully studied. However there is concern that it may influence certain types of cancers that are directly related to hormones (i.e. breast, ovarian, uterine, and prostate cancer). In men it can increase aggression, but upon decrease of dosage this problem can go away. Also, a too-high dosage of DHEA can cause facial hair growth and a deepening of the voice in women.
Read the rest of this article in Freedom From Lupus!
© Health Research Today
