Lupus Treatment

Your rheumatologist will work with you to develop a treatment plan tailored to your symptoms and disease. Your primary care provider may also care for you, coordinate with your specialists and monitor your health.

Depending on your symptoms, you may also work with:

• Dermatologists: To manage skin-related symptoms and complications
• Nephrologists: To treat kidney involvement (lupus nephritis) and monitor kidney function
• Cardiologists: To manage issues like pericarditis (when the sac around the heart becomes irritated or inflamed) and coronary artery disease

Lifestyle changes

These lifestyle adjustments can help manage lupus symptoms and improve your well-being:

• Sun protection: Since UV light can trigger lupus skin rashes and flares, use broad-spectrum sunscreen (SPF 30 or higher), wear protective clothing and avoid direct sun exposure, especially during peak hours.
• Exercise: Regular physical activity, such as walking, swimming or yoga, can help improve joint flexibility, reduce fatigue and support your physical and mental health.
• Diet: Eating a balanced diet rich in fruits, vegetables, whole grains and lean proteins can support your immune function and overall health. You may benefit from reducing processed foods and alcohol. You may need certain diet restrictions if you have high blood pressure, kidney damage or digestive problems.
• Stress management: Stress can worsen lupus symptoms. Deep breathing, meditation or counseling can help reduce stress and improve the way you cope.
• Not smoking: Smoking can make the effects of lupus on your heart and blood vessels worse.
• Vitamin D and calcium: Ask your provider about supplements that may help protect your bone health.

Medications

In addition to lifestyle changes, you’ll probably take medication to reduce inflammation, lower any overactive immune response and manage symptoms. Medications to treat lupus include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs): Medications like ibuprofen (Advil, Motrin) or naproxen (Aleve) help reduce pain, inflammation and fever. Side effects from long-term use may include stomach bleeding and kidney and heart problems.
• Corticosteroids: Prednisone and other corticosteroids can quickly lower inflammation and control severe symptoms during lupus flares. They aren’t usually used long-term because of possible side effects like weight gain, bruising, thinning bones, diabetes, high blood pressure and infection.
• Antimalarial drugs: Hydroxychloroquine (Plaquenil) is commonly prescribed to manage lupus symptoms like joint pain and skin rashes and to help prevent lupus flares. Side effects may include upset stomach and, rarely, damage to the retina in the eye.
• Immunosuppressants: Prescription medications like azathioprine (Imuran, Azasan), cyclosporine (Sandimmune, Neoral, Gengraf), leflunomide (Arava) and methotrexate (Trexall, Xatmep) may help suppress the immune system's response to treat various symptoms of lupus. Drugs like cyclophosphamide (Cytoxan) and mycophenolate (Cellcept) may be used in severe cases that affect the kidneys or brain. Side effects include infection risk, diarrhea, and anemia.  Rare side effects include increased liver damage, cancer risk and decreased fertility with use of a few of the medications.
• Blood thinners: Blood thinners such as heparin (Calciparine or Liquaemin), warfarin pills (Coumadin) or low-dose aspirin can help prevent blood clots. Side effects can include heavy bleeding.
• Biologics: Newer treatments specifically for lupus like belimumab (Benlysta) and anifrolumab-fnia (Saphnelo) and for autoimmune and other diseases like rituximab (Rituxan, Truxima) may target certain parts of the immune system involved in lupus. Side effects may include nausea, diarrhea, infections, depression and allergic reactions.

The first six to 12 months of lupus medication treatment can be challenging, since your providers may ask you to try different medications to find what’s most effective. After that, you may be able to transition to a maintenance mode.

Keep open lines of communication with health care providers about your symptoms, how well your treatment is working and your concerns. Be sure to attend all your appointments so your providers can monitor the disease, adjust your medication if needed and assess your overall health.

Living with lupus

When you’re living with lupus, you’ll want to learn how to manage and minimize flares. Lupus can change and be hard to predict. Key strategies for living with it include:

• Recognizing your triggers: Stress, overexertion, infections and sun exposure can make symptoms worse. Keeping a symptom diary can help pinpoint triggers.
• Monitoring your symptoms: Pay attention to any changes in symptoms and let your health care providers know about them right away. Treating flares quickly can help prevent complications and make symptoms less severe.
• Following your treatment plan: Taking prescribed medications and following treatment recommendations, including lifestyle changes, can help manage symptoms and prevent flares.

Support and resources

Living with lupus can be physically and emotionally challenging. Getting support from others and connecting with resources can help you cope:

• Support groups: With in-person or online support groups, you can connect with others, share experiences and find emotional support.
• Counseling: Individual counseling or therapy can help you navigate the emotional impact of living with a chronic illness and managing stress.
• Educational resources: Health care providers and organizations like the Lupus Foundation of America can give you trustworthy information about lupus so you can make informed decisions about your health and treatment.
• Family and caregiver support: Family members and caregivers can provide support and help you communicate with health care providers.
• Self-care: Getting enough rest, choosing balanced nutrition, managing stress and getting regular physical activity as much as you are able can help your well-being.

To live well with lupus, you’ll want to address the physical and emotional aspects of the condition. By managing symptoms, accessing support and staying informed, you can improve your quality of life and navigate the challenges that can come with this chronic autoimmune disease.

Complications and outlook

Lupus can lead to complications, especially if it is not well-managed or if organs are involved. Common complications can affect:

• Kidneys: Lupus can cause inflammation of the kidneys (lupus nephritis) that can lead to impaired kidney function, excess protein in urine (proteinuria) and in severe cases, kidney failure. Regular monitoring and early intervention may help prevent or slow kidney disease.
• Heart: Lupus increases the risk of problems like inflammation of the heart or surrounding tissues (pericarditis) and coronary artery disease. Managing lupus symptoms and treating risk factors like high blood pressure and high cholesterol are important for heart health.
• Brain and central nervous system: If lupus affects your brain, you may have headaches, dizziness, behavior changes, memory or vision problems, depression, strokes or seizures. 
• Blood and blood vessels: Lupus may lead to a lower amount of healthy red blood cells (anemia) and an increased risk of bleeding or blood clotting. It can also cause blood vessel inflammation.
• Lungs: Having lupus increases your odds of inflammation of the chest cavity lining, which can make it painful to breathe. You may also develop bleeding in your lungs and pneumonia.
• Joints: People with lupus are likely to have arthritis. Pain and stiffness may last a few weeks or be permanent.

Lupus increases your risk of:

• Infection: Both lupus and its treatments can weaken the immune system.
• Cancer: Having lupus may cause a small increase in your risk of cancer.
• Bone tissue death: The blood supply to a bone can drop, leading to small breaks in the bone that eventually make the bone collapse.
• Pregnancy complications: Women with lupus have a higher risk of miscarriage, high blood pressure during pregnancy and preterm birth. If possible, you may want to delay pregnancy until your symptoms have been under control for six months.

The course of lupus can be unpredictable, with times when symptoms are minimal or absent (remission) alternating with flares when symptoms worsen. Some people have mild symptoms that are well-controlled, while others may need intensive treatment.

The prognosis for people with lupus varies depending on how severe symptoms are, which organs are involved, treatment response and overall health. While lupus is a chronic condition with no cure, many people can manage their symptoms and lead active lives with the right medical care and lifestyle changes.

Getting care 

If you have symptoms or need treatment for lupus, connect with Banner Health for expert care. Our primary care, rheumatologists, nephrologists, cardiologists, dermatologists and other health care providers can work with you as a team to make sure you get the best possible care, so you can manage lupus symptoms and minimize their effect on your life.