Systemic Lupus Erythematosus
Symptoms of Lupus continued...
Long-term side effects of corticosteroids can include stretch marks on the
skin, weakened or damaged bones (osteoporosis and osteonecrosis), high blood
pressure, damage to the arteries, high blood sugar (diabetes), infections, and
cataracts. Typically, the higher the dose and the longer they are taken, the
greater the risk and severity of side effects. Researchers are working to
develop ways to limit or offset the use of corticosteroids. For example,
corticosteroids may be used in combination with other, less potent drugs, or
the doctor may try to slowly decrease the dose once the disease is under
control. People with lupus who are using corticosteroids should talk to their
doctors about taking supplemental calcium and vitamin D or other drugs to
reduce the risk of osteoporosis (weakened, fragile bones).
It is dangerous to stop taking corticosteroids suddenly, so it is very
important that the doctor and patient work together in changing the dose.
Immunosuppressives: For some patients whose kidneys or
central nervous systems are affected by lupus, a type of drug called an
immunosuppressive may be used. Immunosuppressives, such as cyclophosphamide
(Cytoxan) and mycophenolate mofetil (CellCept), restrain the overactive immune
system by blocking the production of immune cells. These drugs may be given by
mouth or by infusion (dripping the drug into the vein through a small tube).
Side effects may include nausea, vomiting, hair loss, bladder problems,
decreased fertility, and increased risk of cancer and infection. The risk for
side effects increases with the length of treatment. As with other treatments
for lupus, there is a risk of relapse after the immunosuppressives have been
Other Therapies: In some patients, methotrexate (Folex,
Mexate, Rheumatrex), a disease-modifying antirheumatic drug, may be used to
help control the disease. Working closely with the doctor helps ensure that
treatments for lupus are as successful as possible. Because some treatments may
cause harmful side effects, it is important to report any new symptoms to the
doctor promptly. It is also important not to stop or change treatments without
talking to the doctor first.
Alternative and Complementary Therapies: Because of the
nature and cost of the medications used to treat lupus and the potential for
serious side effects, many patients seek other ways of treating the disease.
Some alternative approaches people have tried include special diets,
nutritional supplements, fish oils, ointments and creams, chiropractic
treatment, and homeopathy. Although these methods may not be harmful in and of
themselves, and may be associated with symptomatic or psychosocial benefit, no
research to date shows that they affect the disease process or prevent organ
damage. Some alternative or complementary approaches may help the patient cope
or reduce some of the stress associated with living with a chronic illness. If
the doctor feels the approach has value and will not be harmful, it can be
incorporated into the patient's treatment plan. However, it is important not to
neglect regular health care or treatment of serious symptoms. An open dialogue
between the patient and physician about the relative values of complementary
and alternative therapies allows the patient to make an informed choice about
Because some treatments may cause harmful side effects...report any new
symptoms to the doctor promptly.