Treatment of lupus
Most drugs lead to serious side effects and their use is the result of an analysis of the potential risks versus benefits. These are the main ones: cortisone (prednisone, prednisolone, dexamethasone, methylprednisolone, hydrocortisone, etc.); immunosuppressant (cyclophosphamide, methotrexate, azathioprine, mycophenolate mofetil, cyclosporine); antimalarial drugs (chloroquine diphosphate, hydroxychloroquine); anticoagulants (warfarin, heparin), among others. Recently a number of new medications, listed as “biological” calls, have been brought to market, bringing hope to those with the most aggressive forms of the disease. Its effectiveness, however, is still being studied.
The lupus patients have, depending on the disease and treatment, increased risk for cardiovascular diseases such as heart attack and stroke. We should therefore always be assisted in reducing risk factors such as cholesterol, hypertension, and smoking. Osteoporosis is also common in these individuals and their prevention is part of a comprehensive approach.
Vaccines such as influenza, pneumococcus, tetanus, Haemophilus influenza and hepatitis-B provide less resistance than SLE to persons in general, but must be used and do not cause reactivation of the disease. Vaccines with live attenuated viruses (bp measles, mumps, rubella, polio, chicken pox, yellow fever) are dangerous and should not be used routinely in patients who are using immunosuppressant drugs.
So far there is no scientific evidence that vitamins for specific diets can modify the development of lupus, and major chronic inflammatory conditions can lead to weakness and weight loss. In these cases a high caloric diet may be helpful. Corticosteroids may lead to increased appetite, obesity and worsening cholesterol. A diet low in calories and cholesterol levels may be interesting for these patients. Two studies support the idea that fish oil with Omega-3 (eicosapentaenoic and docosahexaenoic acids) could reduce disease activity, and improve the function of blood vessels, but they are preliminary and small for what other definitive conclusions can be made. There is no scientific evidence to support the use of herbal medicines and some (bp echinacea) can be harmful.Most people with lupus may live a normal life, but the disease must be carefully monitored and adjusted as necessary during treatment to prevent serious complications.
Even with recent advances in treatment, lupus is chronic, potentially severe, and it disrupts the normal life of the individual forcing himself to a routine of frequent examinations, doctor visits, hospitals, side effects of medications, symptoms and sequelae disease, which these are sometimes permanent. This is particularly difficult to accept in the youth age group most affected by lupus. The uncertainty of its course, treatment failure, and inflammation hormones collaborate together and lead to anger, frustration, depression, loss of hope and the will to fight.