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• Highlights
• Introduction
• Causes
• Risk Factors
• Symptoms
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• Treatment for Cutaneous and Mild SLE
• Treatment for Severe SLE
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Systemic lupus erythematosus

Description

An in-depth report on the causes, diagnosis, treatment, and prevention of lupus.

Alternative Names

Lupus

Highlights

Pregnancy and Lupus

Women with lupus face high risks during pregnancies including maternal death, infection, blood clots, and clotting complications, according to research presented at the 2006 annual meeting of the American College of Rheumatology. Experts recommend that women wait to conceive until their disease has been inactive for at least 6 months.

Oral Contraceptives

Oral contraceptives are safe for women with lupus, as long as their disease is inactive or stable, suggests a New England Journal of Medicine study. Still, women who have been newly diagnosed with lupus and those who are at high risk of blood clots should avoid these drugs.

Nonsteroidal Anti-Inflammatory Drugs (NSAIDs)

• In December 2006, the FDA announced plans to strengthen the warning labels on NSAIDs. The new label will emphasize the bleeding and ulcer risks associated with NSAIDs. People over age 60, patients with a history of ulcers or bleeding, and patients who take blood thinner drugs are especially at risk.
• Many patients with lupus take NSAIDs to relieve joint and muscle pain. Patients who have lupus nephritis should be cautious of these drugs because they can cause fluid retention and reduce kidney function.
• Experts recommend that patients with lupus who take NSAIDs on a regular basis have their liver and kidney function tested every 3 - 4 months.

Investigational Treatments

• Rituximab (Rituxan) has been associated with cases of progressive multifocal leukoencephalopathy (PML), a rare and life-threatening brain infection. In December 2006, the FDA warned of two deaths in patients with lupus who received this drug. Rituximab is approved for lymphoma and rheumatoid arthritis, but not lupus. However, it is being tested in clinical trials for lupus, and some doctors prescribe it “off-label” to their patients.
• Stem cell transplantation may improve the immune system and prolong remission in patients with severe, treatment-resistant lupus, suggests a 2006 study in the Journal of the American Medical Association .

• Review Date: 1/2/2007
• Reviewed By: Harvey Simon, MD, Associate Professor of Medicine, Harvard Medical School; Physician, Massachusetts General Hospital.

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