NSAIDS, nonsteroidal anti-inflammatory drugs, are used to relieve achy joints and arthritis in mild lupus when pain is limited and organs are not affected.
The anti-malarial drug, hydroxycholorquine, is prescribed for lupus-related arthritis and skin problems especially.
Prednisone, a corticosteroid, is prescribed to reduce inflammation and suppress the activity of the overactive lupus immune system. A helpful way to think of prednisone is as a steroidal anti-inflammatory, in contrast to a nonsteroidal anti-inflammatory [NSAID] which is not as potent and doesn’t require a prescription. Prednisone is often used for major organ involvement and other serious complications.
“Off-label” treatments that doctors and patients have used for lupus include the organ transplant drugs azathioprine and mycophenolate mofetil (CellCept®), the rheumatoid arthritis and non-Hodgkins lymphoma drug, rituximab (Rituxan®), and the cancer drug methotrexate. Because these medicines technically have not been FDA-approved for lupus, patients may have difficulty getting insurance coverage for them.
Other medicines to treat complications of lupus are commonly taken by people with the disease. These vary widely and may include blood pressure drugs, anti-clotting medicines (such as 81 mg aspirin), and supplementary calcium to protect bone density, among others.
What You Can Do
During a flare: Get plenty of rest.
When in remission: Exercise to increase joint flexibility and muscle strength.
If you are sensitive to sun: Use sunscreen and avoid the sun.
If rashes persist: check with your doctor about using a cortisone cream.
Relieve stress: Support groups, counseling, talking with friends, family, and doctors can be helpful.
For fever over 100 degrees F: Call your doctor.
Get regular checkups: These usually include blood and urine tests.
Ask questions: When in doubt, call your doctor.
Report any side effects or new symptoms promptly: Help your doctor know when a change in therapy might be needed.
In Spring 2007, the Lupus Research Institute National Coalition sponsored a training day for patient groups, advocates, and leaders on the state of clinical trials for lupus in America today. Top experts from major research universities, pharmaceutical companies, and the Food and Drug Administration offered insights on the growing excitement and challenges of developing, conducting, and having success with clinical trials for lupus.
Just follow the directions here to listen to some of these key presentations.
Click on the links to listen to the presentations in a new browser window. To save the MP3 files to your computer, right-click and select "Save Link As…."
Lupus Epidemiology: Current Status, Long-term Challenges
(Run time: 29 minutes)
Matthew Liang, MD
Professor of Medicine, Harvard Medical School, Boston
Professor of Health Policy, Harvard School of Public Health
About the Presenter:
Dr. Liang is a graduate of Johns Hopkins University in philosophy and chemistry, Harvard Medical School, and the Harvard School of Public Health (HSPH) in tropical public health and epidemiology. He founded and directed the Robert B. Brigham Arthritis and Musculoskeletal Diseases Clinical Research Center at the Brigham and Women's Hospital between 1977-2002 and is currently the Director of Special Projects in the Section of Clinical Sciences.
Dr. Liang is a founding faculty of the Clinical Effectiveness Program at HSPH, a founding member of the BWH Research Institute’s Clinical Research Committee, and a member of the General Clinical Research Center Advisory Committee. He also serves as Chief of the Section of Rheumatology at the VA Boston Healthcare System, and a Study Director in the VA Cooperative Studies Program which has conducted over 550 multi-center clinical trials since its inception.
Dr. Liang has served on the Advisory Council of the National Institute of Arthritis, Musculoskeletal and Skin Diseases, and is currently on the Boards of the Alliance for Lupus Research, the Lupus Clinical Trials Consortium, and Rheuminations, Inc. He serves on the editorial boards of Arthritis and Rheumatism, Lupus, SPINE, The American Journal of Medicine, Nature Clinical Practice Rheumatology, Patient Care, and Current Rheumatology Reviews. He is an active primary care physician and rheumatologist and was named one of the Best Doctors in America.
Download this presentation (Run time: 29 minutes)
Clinical Trials Overview: Moving from Lab to Patient, Types of Trials, Biomarkers/Role in Drug Development
(Run time: 26 minutes)
Benjamin Schwartz, MD, PhD
Professor, Washington University School of Medicine, St. Louis
About the Presenter:
Dr. Schwartz, is a Rheumatologist and Professor of Clinical Medicine at Washington University School of Medicine, and Attending Physician at Barnes-Jewish Hospital in St. Louis, Missouri. He is also a Principal and Co-Founder of The Camden Group, a consulting group which assists biotech and pharmaceutical companies in designing clinical trials and clinical research programs.
Prior to founding the Camden Group, Dr. Schwartz was Senior Director of Clinical Research at G.D. Searle Research and Development, where he directed the clinical trials on CelebrexÒ. After earning his PhD in immunology and his MD from Albert Einstein College of Medicine in the Bronx, New York, he completed his residency and internship at Bronx Municipal Hospital Center. He then spent two years as a Research Associate in the Laboratory of Immunology at the National Institutes of Allergy and Infectious Diseases of the NIH.
Dr. Schwartz joined the faculty of the Department of Medicine at Washington University School of Medicine, where he was also an Investigator of the Howard Hughes Medical Institute, and Chief of Rheumatology at Jewish Hospital. He is a past President of the American Federation of Clinical Research and is a member of the Scientific Advisory Board of the Lupus Research Institute, and has served in numerous other positions including Chairman of the Research Council of the American College of Rheumatology (ACR), and Chairman of the NIH Allergy and Immunology Study Section. Dr. Schwartz is the author of over 150 original research articles, review articles, and chapters in text books.
Download this presentation (Run time: 26 minutes)
Trial Design: Glossary of Terms, Trial Design, Measuring Outcomes
(Run time: 2 hours 45 minutes)
Jill Buyon, MD
Professor, New York University School of Medicine, New York
About the Presenter:
Dr. Buyon is a Professor of Medicine and Associate Director of the Division of Rheumatology at NYU School of Medicine. She is also Vice Chairman of the Department of Rheumatology at New York's Hospital for Joint Diseases.
Dr. Buyon is the author or co-author of more than 120 peer-reviewed original reports, and has received numerous awards and honors, including Alphan Omega Alspha (1978), the Fabian Award for Excellence in Research (1988; 1991), and the Distinguished Clinical Investigator Award from the American College of Rheumatology (2006).
Dr. Buyon is a member of the American College of Rheumatology (1984 to present), the American Federation for Medical Research (1986 to present), and the American Association for the Advancement of Science (1988 to present). She served on the editorial board of Arthritis & Rheumatism from 1992 to 1996, and currently serves on the editoral board for Lupus (1997 to present).
Download this presentation (Run time: 2 hours 45 minutes)
Regulatory Agency: The FDA Process
(Run time: 22 minutes)
Sarah Okada, MD
Food and Drug Administration
Dr. Okada is a Medical Team Leader in the Division of Anesthesia, Analgesia, and Rheumatology products at the FDA. Prior to joining the Agency, she completed her Rheumatology fellowship at the NIH, where she participated in clinical and basic research. Before that, she served for 10 years as a medical officer and general internist in the US Army.
Download this presentation (Run time: 22 minutes)
Identifying the Targets: The Importance of Basic Science, Identifying Molecules, The Role of Animal Studies
(Run time: 21 minutes)
Leonard Sigal, MD
Director in Immunology, Bristol Myers-Squibb
About the Presenter:
Dr. Leonard H Sigal is past Chief of the Division of Rheumatology at UMDNJ-Robert Wood Johnson Medical School and currently Clinical Professor in the Departments of Medicine and Pediatrics, as well as a Director in the Immunology section of the Pharmaceutical Research Institute of Bristol-Myers Squibb, where he works on the development of medication to control auto-immune and inflammatory diseases.
Dr. Sigal graduated from Stanford Medical School and did internal medicine training at Mt Sinai Medical Center in NY, followed by fellowships in rheumatology and in immunology at Yale University School of Medicine. During his academic career Dr Sigal spent over 20 years researching Lyme disease, including aspects of its immunopathology and immunopathogenesis, improved techniques for serological and cellular confirmation of the diagnosis of Lyme disease, and the epidemiology of the disease. Now, in collaboration with Afton Hassett, Psy D of the Division of Rheumatology, Dr Sigal is exploring aspects of the “psychopathogenesis” of “chronic Lyme disease,” an area he has been describing and researching for the past decade. Dr Sigal has written nearly 200 papers and chapters, as well as a textbook on immunology.
Download this presentation (Run time: 21 minutes)
Pathogenesis: Overview of the Disease Process
(Run time: 37 minutes)
John A. Hardin, MD
Professor, Albert Einstein College of Medicine, New York
About the Presenter:
Dr. Hardin completed his residency and fellowship training in internal medicine at Strong Memorial Hospital in Rochester prior to a postdoctoral fellowship in rheumatology at Massachusetts General Hospital. He joined the American Board of Internal Medicine Subspecialty Board on Rheumatology in 1996, and has been chair of this subspecialty board since 2002.
Dr. Hardin is a member of Alpha Omega Alpha, the Arthritis Foundation, the American College of Rheumatology, the American Rheumatism Association, the American Society of Clinical Investigation, the American Association of Physicians, the Association of Professors of Medicine, and the Southern Society for Clinical Investigation.
Dr. Hardin has served as Physician-in-Chief pro tempore, Hospital for Special Surgery, New York City.
Download this presentation (Run time: 37 minutes)