Lupus treatment often involves a combination of medications, lifestyle adjustments, and ongoing health monitoring.

Because there’s currently no cure for lupus, treatment is primarily focused on reducing the severity and frequency of flare-ups while helping prevent long-term complications and organ damage. 

Lupus presents differently from person to person. Finding the best treatment plan typically involves a lot of trial and error. This often means becoming familiar with tracking symptoms, triggers, and how your body responds to different treatments over time.

With this in mind, we put together this lupus treatment guide for you to use as a starting point. Not every medication and intervention on this list may be a good fit for you, but it’s helpful to have as much information as possible as you work with your doctor to manage lupus.

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What is lupus?

Lupus is an autoimmune condition that causes the immune system to target, attack, and damage healthy organs and tissues throughout the body. There are multiple subtypes, but the most common presentation is systemic lupus erythematosus (SLE).

Most people with lupus experience two distinct disease states:

• Active—when they have a flare and experience symptoms
• Inactive—periods of remission with mild or no symptoms

The goal of lupus treatment is to prolong periods of remission. This helps reduce symptoms and complications from organ damage.

During a flare, symptoms can develop relating to the skin, blood vessels, joints, kidneys, brain, heart, and lungs. Examples of lupus symptoms include:

• Fatigue
• Joint pain, swelling, and stiffness, particularly in the morning
• Skin rashes, including a “butterfly rash” across the cheeks and nose or scaly rashes on other parts of the body
• Sensitivity to the sun
• Hair loss
• Fever
• Mouth sores
• Shortness of breath
• Headaches
• Brain fog, confusion, or memory problems
• Swollen glands
• Changes in finger or toe color in response to cold or stress (Raynaud’s phenomenon)
• Swelling (edema)

Understanding how lupus is diagnosed

No single test can confirm a lupus diagnosis. Instead, you’ll likely go through a multi-test screening process that includes:

• Blood work: Your doctor may order various tests, including a complete blood count, erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), and kidney and liver panels. It’s also common to test for antinuclear antibodies (ANA), as 98% of people with systemic lupus have a positive ANA test.

• Urine tests: Urinalysis helps rule out infections or other conditions that may be causing symptoms. It also helps identify signs of lupus-related kidney damage.

• Skin and/or kidney biopsies: Depending on your symptoms, biopsies of your skin and kidneys can help confirm a lupus diagnosis.

Important note: Having lupus symptoms doesn’t mean you have the condition. In many cases, diagnostic testing rules out other causes.

Lupus treatments: Exploring your options

Medical researchers haven’t yet found a cure for lupus. As a result, treatment plans typically focus on reducing disease activity, managing symptoms, and helping prevent long-term complications through medications and lifestyle changes.

The type of treatment recommended depends on how severe your lupus is and which parts of the body are affected. For example, people with organ involvement, such as lupus nephritis affecting the kidneys, may require more intensive treatment and monitoring.

Lupus medications

It’s very common for people living with lupus to take medications. In most cases, finding the right medication regimen and dosage requires some trial and error.

Here is a list of the most commonly prescribed medications for managing lupus:

Antimalarials

Antimalarials, medications commonly used to prevent and treat malaria, are a first-line therapy for managing lupus. Most people with lupus take antimalarials throughout their lives to reduce symptoms.

Antimalarials work by reducing autoantibodies in the body, which helps reduce the frequency of lupus flares. They are taken orally in pill or liquid form.

Examples of antimalarials for lupus include:

• Hydroxychloroquine (Plaquenil®)
• Chloroquine (Aralen®)

Antimalarials can take 1–3 months to come into full effect. Tracking side effects and symptom severity during that time can help determine if the medication is a good fit for your needs.

Steroids

Steroid medications can help reduce the pain and inflammation associated with lupus. They are commonly prescribed at low doses for long-term treatment, but your doctor may recommend a higher dose to help manage symptoms during a flare.

Lupus steroid therapy can be taken orally as pills.

The most commonly prescribed steroids for lupus include:

• Prednisone (Rayos®)
• Prednisolone (Pediapred®, Prelone®)
• Methylprednisolone (Medrol®)

NSAIDs

NSAIDs, non-steroidal anti-inflammatory drugs, are a common type of pain medication that can help manage pain symptoms caused by lupus. They help minimize inflammation by reducing inflammatory chemicals in the body.

NSAIDs are taken orally in pill form and usually work within a few days.

Some of the most commonly prescribed NSAIDs for lupus include:

• Ibuprofen (Advil®, Motrin®)
• Naproxen (Aleve®, Naprosyn®)
• Indomethacin (Indocin®)
• Nabumetone (Relafen®)
• Celecoxib (Celebrex®)
• Aspirin

Important note: While many NSAIDs are available over the counter, you should not start taking NSAIDs for your lupus symptoms without consulting your doctor first.

Immunosuppressants

Immunosuppressants prevent your immune system from overactivating and attacking your healthy cells. They are commonly used in more severe cases of lupus where there is damage to essential organs like the heart, lungs, kidneys, or brain.

Bear in mind that immunosuppressants increase your risk of developing other infections. While taking them, you’ll need to monitor your symptoms closely and avoid situations that put you at risk of becoming ill.

Immunosuppressants can be administered in pill, liquid or injection form.

Some of the most common immunosuppressants used for lupus include:

• Methotrexate (Rheumatrex®)
• Mycophenolate mofetil (Cellcept®)
• Azathioprine (Imuran®)
• Cyclophosphamide (Cytoxan®)

Some immunosuppressants, such as voclosporin (Lupkynis®), are specifically approved to treat lupus nephritis.

Anticoagulants

People with lupus have a higher risk of developing blood clots due to ongoing blood vessel damage. Your doctor may recommend taking anticoagulants (blood thinners) to reduce that risk.

Anticoagulants are taken orally or as an injection. Examples include:

• Heparin (Calciparine®, Liquaemin®)
• Warfarin (Coumadin®)

Monoclonal antibodies (mAbs)

Monoclonal antibodies are naturally occurring proteins in the body. Variations can be developed in the lab that attach to specific substances in the body, helping control parts of the immune system involved in lupus inflammation and disease activity.

Monoclonal antibodies are administered by a medical professional, either by IV infusion or injection.

Examples of mAbs for lupus include:

• Anifrolumab-fnia (Saphnelo®)
• Belimumab (Benlysta®)
• Obinutuzumab (Gazyva®)

Adrenocorticotropic hormone (ACTH) gels

ACTH gel is an artificial version of a naturally occurring hormone. It works by stimulating the adrenal glands to produce hormones such as cortisol, which help reduce inflammation.

ACTH gel may be used to help manage joint inflammation and pain, particularly in people who don’t respond to other treatments.

Examples include:

• Acthar® Gel
• Purified Cortrophin® Gel

ACTH gels are administered as injections, either by a doctor or through self-injection at home after training from a healthcare provider.

Managing lupus symptoms through lifestyle changes

Your doctor may recommend lifestyle changes that help reduce your risk of experiencing a lupus flare.

While triggers differ from person to person, some lifestyle changes may help reduce the risk of flare-ups and support overall health.

• Avoiding direct sun exposure and using sunscreen
• Quitting smoking
• Exercising regularly
• Avoiding stress
• Eating a balanced diet and paying attention to foods that may worsen symptoms for you
• Keeping a symptom journal to identify triggers and patterns over time

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Turn treatment into data

Managing lupus involves trial and error to discover what triggers your symptoms and identify the best medications and lifestyle modifications for you.

But trial and error can only go so far without effective tracking. Most people find using a tracking app to be the simplest, most effective way to collect the data they need.

Using Human Health, you can track your symptoms, including how they change, what triggers your symptoms, and how you react to lupus medications and lifestyle changes. Over time, you can see what’s changing, what’s helping, and what perhaps isn’t helping, and share those insights with your doctor.

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Frequently asked questions

Does lupus get worse with age?

Many people with lupus find that their condition becomes less severe with age. As we get older, our immune system activity decreases, which reduces the amount of inflammatory proteins produced.

The severity of your symptoms with age will depend on how much damage lupus caused to your organs and tissues while it was most active in your body.

Is there a cure for lupus?

There is currently no definitive cure for lupus. Lupus treatment is primarily focused on reducing symptom severity and the risk of experiencing a flare-up. Medications and lifestyle changes are the current leading treatment options for managing lupus.

Is lupus serious?

Yes, lupus is a serious medical condition that can become life-threatening if not monitored and managed.

If you or someone you love has been diagnosed with lupus, diligently tracking symptoms, the effects of medications, and potential triggers is key to successfully managing the condition and improving quality of life. 

Disclaimer: Human Health is a health tracking platform and does not provide medical advice, diagnosis, or treatment. The information in this guide is for educational purposes only and is not a substitute for professional medical care. Always consult your doctor or healthcare provider with questions about your health.

Sources:

1. Systemic lupus erythematosus (2023)
2. Systemic lupus erythematosus (lupus), The National Institute of Arthritis and Musculoskeletal and Skin Diseases
3. Lupus, Mayo Clinic
4. Lupus blood tests, Johns Hopkins Lupus Center
5. Medications used to treat lupus, The Lupus Foundation of America
6. Dos and don’ts for living well with lupus, The Lupus Foundation of America
7. Lupus support groups, The Lupus Foundation of America
8. Lupus & you Q&A: Aging with purpose, The Lupus Foundation of America