There are many different pharmacologic options for treatment/management of Systemic Lupus Erythematosus (SLE). While there is no cure for this autoimmune disease, the goal is to control the progression of the disease through pharmaceutical therapies. Combination therapy may also be appropriate. It is essential to develop a unique, individualized plan with your Rheumatologist so that the appropriate intervention be utilized based on disease location and severity.
Pharmacotherapy includes classes of drugs such as Antimalarials, Corticosteroids, Non-biologic DMARDS, biologic DMARDS, and NSAIDS. All of these medications have side effects, and the risks versus the benefits should be weighed before any intervention.
Antimalarial medications such as Plaquenil have been used to control the progression of SLE. Corticosteroids, commonly used in Prednisone, are added to treatment plans to decrease the inflammation associated with Lupus. Non-biologic DMARDS, such as Methotrexate, and biologic DMARDS, such as rituximab, are also used to stabilize the condition.
There is a specific protocol that must be followed for treatment of SLE. It is imperative that a unique treatment plan is developed for your individual stage of SLE. Combination therapy may be suggested.
Some of the medications may be short term and others may be long term therapy. It can be a tedious process to determine the most appropriate therapy that will allow for best symptom control and delayed disease progression. Therefore, it is essential to have regular follow ups with your Rheumatologist.
Prognosis:
The prognosis of the disease actually depends on how many organ systems are involved, as well as how far the disease has progressed prior to diagnosis and therapeutic intervention. Other factors may influence prognosis as well.
It has been shown that SLE patients with skin and musculoskeletal systems involvement only have an association with a better prognosis when compared to SLE patients who have multiple organ systems involved.
The mortality has greatly decreased over the past couple decades. There has been a great research and earlier interventions that allow for improved survival rates. Before the therapeutic intervention, SLE patients death was associated with the disease. However, the disease associated deaths for SLE patients have significantly decreased over the past few decades and the deaths are now associated with complications, or from reactions to medications.
The survival rate has increased from less than 50% (considering a 5-year survival rate) in 1955 to greater than 90% (considering a 10-year survival rate) currently. There have been great strides in the early diagnosis of SLE, and subsequent early treatment. Understanding and educating patients on how important early diagnosis and treatment truly are to the overall prognosis of the disease is imperative, in order to continue to increase survival times.
