Lupus is much more common in women than in men, and it also affects people of Afro-Caribbean, Chinese and Southeast Asian origin more frequently.
What is Lupus?
ystemic lupus erythematosus, commonly referred to as SLE or simply SLE, is a chronic disease which causes inflammation and damage to multiple organs. It is also an autoimmune illness, which means that it occurs because the patient’s immune system attacks its own tissues and organs because it mistakenly thinks they are foreign tissues. It is characterized by the presence of antinuclear antibodies in the patient’s blood.
There are other, less common types of lupus, such as:
What Causes Lupus?
The exact cause of lupus is unknown. Genetics might be a contributing factor, since it has been found that lupus can run in families. Other possible triggers are hormonal changes, medications (for example hydralazine, methyldopa, minocycline, d-penicillamine, chlorpromazine, and isoniazid), infections, and environmental factors.
How is Lupus Diagnosed?
Doctors first suspect lupus depending on the patient’s symptoms. The clinical presentation of lupus varies greatly from one person to another and the disease goes through periods of remission and relapse, but symptoms can include:
- Arthralgia: painful joints.
- Malar rash: a butterfly-shaped facial rash, which can itch.
- Weight loss
- Dry eyes and mouth
- Myalgia: muscular pain.
- Raynaud’s phenomenon
- Chest pain
Systemic lupus erythematosus can affect every system in the body, including the heart, digestive system, kidneys, lungs, and nervous system.
Once your doctors suspect lupus as the cause of your symptoms, they will order laboratory tests to determine the presence of antinuclear antibodies in your blood. Patients with lupus often also have another antibody called anti-double-stranded DNA (anti-dsDNA) present in their blood.
The American College of Rheumatology has compiled a list of criteria to help reach a diagnosis in patients who display certain symptoms.
Although there isn’t currently a cure for systemic lupus erythematosus, its symptoms can be managed through a variety of treatments. Since lupus produces different symptoms in each patient, the treatment will be individualized to better treat those specific symptoms.Some patients with mild symptoms can use medications intermittently or not at all.
Nonsteroidal anti-inflammatory drugs or NSAIDs such as naproxen, ibuprofen or aspirin are used to treat arthralgia and myalgia. NSAIDs can cause stomach ulcers, so misoprostol is sometimes used in conjunction to prevent this side effect.
Corticosteroids also reduce inflammation, and are often used when the disease causes organ damage. These drugs have multiple and serious side effects, so their use must be closely monitored by the patient’s medical team. These side effects can include weight gain, osteopenia, osteoporosis, and infections.
Antimalarial drugssuch as hydroxychloroquine and chloroquine are used to treat fatigue, joint symptoms, and skin lesions. They also relieve general symptoms and prevent flare-ups. Hydroxychloroquine has shown to be effective in preventing abnormal blood clotting.
Cytotoxic or immunosuppressive drugs, such as cyclophosphamide, cyclosporine, methotrexate, and azathioprine are also used to treat severe cases of systemic lupus erythematosus. Cytotoxic drugs can cause severe side effects such as liver and kidney toxicity.
Rituximab, a chimeric monoclonal antibody which is infused intravenously and destroys B cells, thus decreasing the severity of lupus and even making it go into remission. Belimumab was approved in 2011 and acts as a B-lymphocyte stimulator or BLyS-specific inhibitor which inhibits the production of B cells.
Plasmapheresis is a process during which blood plasma is removed from the body and filtered before being returned to circulation. This procedure is used to remove antibodies from the patient’s blood, and it is performed when there is severe kidney or brain damage. Plasmapheresis also removes cryoglobulins, which are proteins that can cause vasculitis. Patients with severe kidney disease stemming from systemic lupus erythematosus need to receive dialysis or a kidney transplant.
Lupus Clinical Trials
The treatment and prognosis of lupus patients has been greatly improved thanks to clinical trials. Through these trials, new drugs or procedures are tested, helping researchers discover which treatments are most effective, what side effects they can cause, and how to improve patients’ quality of life.
Clinical trials are conducted by universities, hospitals, or organizations under the guidance of a medical team. Participants not only get to help to develop new treatments, but also have access to expert healthcare and new medical developments. If you are interested in participating in a clinical trial, ask your doctor about trials open in your area or contact hospitals and universities near you.
ClinicalTrials.gov: Recruiting Studies | lupus | Last update posted in the last 300 days Studies found on ClinicalTrials.gov by a search of: Recruiting Studies | lupus | Last update posted in the last 300 days
Study to Assess Safety and Effectiveness of Branebrutinib Treatment in Participants With Active Systemic Lupus Erythematosus or Primary Sjögren's Syndrome, or Branebrutinib Treatment Followed by Open-label Abatacept Treatment in Study Participants With Active Rheumatoid Arthritis
on December 5, 2019 at 5:00 pm
Conditions: Autoimmune Disorder; Rheumatoid Arthritis; Systemic Lupus Erythematosus; Primary Sjögren's SyndromeInterventions: Drug: branebrutinib; Drug: abatacept; Drug: branebrutinib placeboSponsor: Bristol-Myers SquibbRecruiting
Treatment of Systemic Lupus Erythematosus With Pooled Allogenic Mesenchymal Stem Cells
on December 3, 2019 at 5:00 pm
Condition: Systemic Lupus ErythematosusInterventions: Biological: Pooled mesenchymal stem cell; Other: Standard treatment according to the Clinical protocolsSponsors: Institute of Biophysics and Cell Engineering of National Academy of Sciences of Belarus; Belarusian State Medical UniversityRecruiting
Study of Subcutaneous (SC) Belimumab in Pediatric Participants With Systemic Lupus Erythematosus (SLE)
on November 26, 2019 at 5:00 pm
Condition: Systemic Lupus ErythematosusIntervention: Combination Product: BelimumabSponsor: GlaxoSmithKlineRecruiting
LUPUS Brain: tACS to Target the Neurophysiology of Depression, Cognitive Deficits, and Pain in Patients With SLE
on October 28, 2019 at 4:00 pm
Conditions: Systemic Lupus Erythematosus; DepressionInterventions: Device: XCSITE100 Stimulator - Individualized theta-tACS; Device: XCSITE100 Stimulator - Individualized alpha-tACS; Device: XCSITE100 Stimulator - Active ShamSponsor: University of North Carolina, Chapel HillRecruiting
Study of EQ001 (Itolizumab) in Systemic Lupus Erythematosus With or Without Active Proliferative Nephritis
on October 16, 2019 at 4:00 pm
Conditions: Lupus Erythematosus; Lupus NephritisInterventions: Drug: Itolizumab [Bmab 600]; Drug: EQ001 PlaceboSponsors: Equillium; Biocon LimitedRecruiting
Study of Recombinant Human B Lymphocyte(RC18) Administered Subcutaneously to Subjects With Systemic Lupus Erythematosus(SLE)
on September 9, 2019 at 4:00 pm
Condition: Systemic Lupus ErythematosusInterventions: Biological: Placebo plus standard therapy; Biological: RC18 160 mg plus standard therapySponsor: RemeGenRecruiting
Application of MRI for Musculoskeletal Involvement in SLE
on July 29, 2019 at 4:00 pm
Conditions: Hand Rheumatism; Systemic Lupus Erythematosus ArthritisIntervention: Procedure: Blood testSponsor: Hospital del MarRecruiting
Predictors of Mortality in Patients With Autoimmune Diseases Admitted to the Intensive Care Unit
on July 17, 2019 at 4:00 pm
Conditions: Vasculitis; Systemic Lupus Erythematosus; MyositisIntervention: Other: ICU CareSponsors: University of Göttingen; University Medical Center GoettingenRecruiting
Translation of a Diagnostic Test for Lupus Flare Prediction From Bench to Clinic
on July 12, 2019 at 4:00 pm
Conditions: System; Lupus Erythematosus; Lupus Erythematosus; SLE; Lupus FlareIntervention: Sponsors: Progentec Diagnostics, Inc.; Oklahoma Center for the Advancement of Science and TechnologyRecruiting
A Study to Investigate the Safety and Efficacy of ABBV-105 and Upadacitinib Given Alone or in Combination in Participants With Moderately to Severely Active Systemic Lupus Erythematosus
on June 7, 2019 at 4:00 pm
Condition: Systemic Lupus Erythematosus (SLE)Interventions: Drug: ABBV-105; Drug: Placebo for ABBV-105; Drug: Upadacitinib; Drug: Placebo for upadacitinibSponsor: AbbVieRecruiting
Efficacy and Safety of Delgocitinib Cream in Discoid Lupus Erythematosus.
on May 22, 2019 at 4:00 pm
Condition: Discoid Lupus ErythematosusInterventions: Drug: Delgocitinib cream; Drug: Delgocitinib cream vehicleSponsor: LEO PharmaRecruiting
Effect of Curcumin on Systemic Lupus Erythematosus
on May 16, 2019 at 4:00 pm
Condition: Systemic Lupus ErythematosusIntervention: Drug: Curcumin supplementSponsor: Loma Linda UniversityRecruiting
Safety and Efficacy of SM934 Compared to Placebo in Adult Subjects With Active Systemic Lupus Erythematosus
on May 15, 2019 at 4:00 pm
Condition: Systemic Lupus ErythematosusInterventions: Drug: SM934; Drug: PlacebosSponsors: RenJi Hospital; Jiangsu ZuoYou Medicine Co., Ltd.Recruiting
An Investigational Study to Evaluate the Safety and Effectiveness of BMS-986165 With Background Treatment in Participants With Lupus Nephritis
on May 9, 2019 at 4:00 pm
Condition: Lupus NephritisInterventions: Drug: BMS-986165; Drug: PlaceboSponsor: Bristol-Myers SquibbRecruiting
Systemic Lupus Erythematosus Exercise Program
on May 8, 2019 at 4:00 pm
Condition: Systemic Lupus ErythematosusIntervention: Other: ExerciseSponsors: University Medical Center Mainz; Johannes Gutenberg University MainzRecruiting
Spontaneous Coronary Artery Dissection (SCAD) and Autoimmunity
on May 7, 2019 at 4:00 pm
Conditions: SCAD; Addison Disease; Ankylosing Spondylitis; Antiphospholipid Antibody Syndrome; Celiac Disease; Crohn Disease; Dermatomyositis; Polymyositis; Guillain-Barre Syndrome; Hepatitis, Autoimmune; Graves Disease; Hashimoto Thyroiditis; Multiple Sclerosis; Myasthenia Gravis; Pernicious Anemia; Polymyalgia Rheumatica; Primary Biliary Cirrhosis; Psoriasis; Rheumatoid Arthritis; Systemic Sclerosis; Sjögren Syndrome; Systemic Lupus Erythematosus; Takayasu Arteritis; Type 1 Diabetes Mellitus; Ulcerative Colitis; Uveitis; Vasculitis; Vitiligo; RaynaudIntervention: Sponsor: Mayo ClinicRecruiting
Peer i-Coaching for Activated Self-Management Optimization in Adolescents and Young Adults With Chronic Conditions
on May 6, 2019 at 4:00 pm
Conditions: Sickle Cell Disease; Chronic Kidney Diseases; Systemic Lupus Erythematosus; Childhood Cancer; Inflammatory Bowel Diseases; Asthma; Stem Cell Transplant; Organ Transplant; Diabetes Mellitus, Type 1Interventions: Behavioral: PiCASO Intervention Group; Behavioral: Sham Comparator: Attention Control GroupSponsors: Duke University; National Institutes of Health (NIH); National Institute of Nursing Research (NINR)Recruiting
Internet-Based Pain Coping Skills Training for Patients With Lupus
on May 1, 2019 at 4:00 pm
Condition: Lupus Erythematosus, SystemicIntervention: Behavioral: PainCOACHSponsor: University of North Carolina, Chapel HillRecruiting
A Study of LY3361237 in Participants With Systemic Lupus Erythematosus
on May 1, 2019 at 4:00 pm
Condition: Lupus Erythematosus, SystemicInterventions: Drug: LY3361237; Drug: PlaceboSponsor: Eli Lilly and CompanyRecruiting
KOrea Renal Biobank NEtwoRk System TOward NExt-generation Analysis
on April 29, 2019 at 4:00 pm
Conditions: Glomerular Disease; Minimal Change Disease; IgA Nephropathy; Membranous Nephropathy; Focal Segmental Glomerulosclerosis; Lupus Nephritis; Crescentic GlomerulonephritisIntervention: Other: Kidney BiopsySponsors: Seoul National University Hospital; Chung-Ang University Hosptial, Chung-Ang University College of Medicine; KangWon National University Hospital; Keimyung University Dongsan Medical Center; SMG-SNU Boramae Medical Center; Seoul National University Bundang Hospital; Severance Hospital; Ministry of Health & Welfare, KoreaRecruiting
Patients with systemic lupus erythematosus need to rest more when they are going through a flare-up; however, exercise is still necessary to prevent muscle atrophy.
Although there isn’t a specific diet for lupus patients, they should follow a healthy and balanced diet. A patient could require more calories during an active phase of lupus. Decreasing salt intake can help with swelling and edema. Also, patients who take corticosteroids should take calcium and vitamin D supplements to avoid osteopenia and osteoporosis. Although alcohol isn’t contraindicated in lupus, it may interact with the medications a patient is taking; therefore, patients should be made aware of any possible interactions.
In order to prevent dermal lesions, sun exposure should be avoided and sunscreen must be worn to protect the skin. Wearing long sleeve tops and hats is recommended on sunny days.
- Research the disease, its symptoms, complications, and consequences in order to be able to understand what your loved one is going through.
- Make sure there are healthy and balanced meals available to suit the needs of a lupus patient.
- Be understanding when your loved one is going through a flare-up, since they will likely need more rest than usual; offer help, and ask what the other person needs.
- Offer encouragement and support to your loved one.
- Tidy, C. (2015, Feb. 3rd). Systemic Lupus Erythematosus. Retrieved from https://patient.info/health/systemic-lupus-erythematosus-leaflet#nav-8
- Wallace, D. (2017, Jan. 10th) Patient education: Systemic lupus erythematosus (SLE) (Beyond the Basics). Retrieved from https://www.uptodate.com/contents/systemic-lupus-erythematosus-sle-beyond-the-basics