Living With Lupus: Can You Recognize The Signs?

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ngd-Later in the article, there is a discussion of new treatments worth reviewing…

f you have lupus, you know it’s a challenge to treat. Lupus is an autoimmune disease, a condition that occurs when the body mistakes its own tissue as foreign and attacks itself.

Lupus can result in an attack on many body systems, including the joints, skin, kidneys, heart, lungs, blood vessels and brain.

Lupus, also known scientifically as Systemic Lupus Erythematosus (SLE), often results in symptoms of:

  • mouth sores
  • rash, fatigue
  • joint pain and swelling
  • kidney damage.

The cause of lupus is not fully known, and in severe cases, lupus can be fatal. Research data suggests that in people with lupus, some of the immune system’s “B cells” mature the wrong way – so that they promote inflammation instead of fighting it. It’s cause is probably a mix of genetics and environmental factors.

How to Treat Lupus: Older Stand-Bys

While great advances are being made in lupus, there is no cure yet. Treatments act to limit symptoms, prevent organ damage, and lower the risk of flare-ups.

Common drugs used to treat lupus include:

  • NSAIDs like naproxen sodium (Aleve) and ibuprofen (Advil, Motrin IB, others) can help to relieve joint and muscle pain and relieve fever.
  • Hydroxychloroquine (Plaquenil) or chloroquine. Almost everyone receives one of these medicines daily to help with fatigue and fever, muscle pain, and skin symptoms, as well as lowering the number of flares.
  • Corticosteroids, like prednisone, are used in patients that have organ involvement and inflammation, but their benefits should be weight against possible side effects like increased risk of infection, bone thinning, weight gain or diabetes.
  • Immunosuppressants like: azathioprine (Imuran, Azasan), mycophenolate (CellCept), leflunomide (Arava), and methotrexate (Trexall).

Older medicines may work well for lupus but tend to suppress the whole immune system which can lead to elevated risk for infections and troublesome side effects.

Systemic Lupus Treatment: Benlysta

In 2011, the FDA approved the new drug Benlysta (belimumab), the first lupus treatment since 1955.

  • It is approved by the FDA for the treatment of patients aged 5 years and older with active, autoantibody‑positive, systemic lupus erythematosus (SLE) who are receiving standard therapy.
  • The pediatric use for SLE was approved in 2019.
  • In Dec. 2020, the FDA approved Benlysta to treat adults with active lupus nephritis (LN) who are receiving standard therapy.

Benlysta is a monoclonal antibody that targets the B-lymphocyte stimulator (BLyS) protein and lowers abnormal B cells (B cells normally produce antibodies to fight disease, but B cells can attack the body, too, in lupus).

Lupkynis OK’d for Lupus Nephritis

Kidney disease is a fairly common complication of lupus, affecting up to 50% of adults and 80% of children. Lupus nephritis (LN) is a type of kidney disease caused by lupus that can eventually lead to kidney failure, heart complications, the need for dialysis or death.

In Jan 2021 the FDA approved Lupkynis (voclosporin), a calcineurin-inhibitor immunosuppressant used with an immunosuppressive regimen to treat adult patients with active lupus nephritis (LN). The recommended starting dose is 23.7 mg orally every 12 hours on an empty stomach. Lupkynis is from Aurinia Pharmaceuticals.

Saphnelo (anifrolumab) from AstraZeneca

In July 2021, the FDA approved Saphnelo (anifrolumab), a first-in-class type I interferon (IFN) receptor antagonist to treat adults with moderate to severe systemic lupus erythematosus (SLE), who are receiving standard therapy.

Saphnelo works by binding to subunit 1 of the type I IFN receptor, blocking the activity of type I IFNs, which are commonly found in patients with SLE.

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