Medicines
Investigational Drugs
A number of investigational (research) drugs for lupus are currently being studied in clinical trials. Promising new treatments include hormone modifications, more selective immunosuppressive drugs, and biologic agents.
Researchers are studying biologic agents to selectively block pathways of the immune system from forming autoantibodies involved in the inflammation and damage that occurs in lupus. This is a new and exciting approach for both treating and preventing the disease.
Table 1.
Principal drugs used in the management of lupus
I. Non Major Organ Involvement
(fever, arthritis, pleurisy/pericarditis, rash)
|
Category |
Drug (Brand) Name |
Major Side Effects |
|
Non-Steroidal Anti-inflammatory |
Diclofenac (Cataflam, Voltaren) |
Abdominal pain, heartburn, gastric ulcers and bleeding, fluid retention, rashes, kidney or liver damage, dizziness or confusion, headache |
|
Anti-Malarials |
hydroxychloroquine (Plaquenil) |
Nausea, abdominal pain/cramps, rash, skin pigmentation, weakness, blurred vision, headache, eye damage. |
|
Corticosteriods |
Topical Creams/Ointments (for lupus rashes) halobetasol (Ultravate) hydrocortisone (Cortef, Cortaid) triamcinolone (Aristocort, Kenalog) betamethasone (Valisone, Diprosone) fluocinolone (Synalar) fluocinonide (Lidex) |
Skin thinning and pigment changes, superficial blood vessel formation |
|
Tablets prednisolone (Prelone) methylprednisolone (Medrol) |
Weight gain, round or moon shaped face, mood changes, thin/fragile skin, acne, diabetes, facial hair, cataracts, osteoporosis, osteonecrosis, muscle weakness, hypertension, gastric ulcers, infections | |
|
Intravenous hydrocortisone (Solu-Cortef) |
Metallic taste, infections, nervousness | |
|
Cytotoxics and Immunosuppressives |
methotrexate (Rheumatrex) |
Nausea, abdominal pain, mouth ulcers, rashes, cough, shortness of breath, lung or bone marrow damage |
| azathioprine (Imuran) | Nausea or vomiting, pancreatitis, infection, liver disease, cancer |
II. Major Organ Involvement
(nephritis, neurologic disease, etc.)
|
Category |
Drug (Brand) Name |
Major Side Effects |
| Corticosteroids | See above; typically used in higher doses or as intravenous infusion | See above |
| Cytotoxics and Immunosuppressives |
azathioprine (Imuran) |
See above |
| cyclophosphamide (Cytoxan) | Nausea or vomiting, rash,infection, hair loss, bladder damage, infertility, cancer | |
| chlorambucil (Leukeran) | Nausea or vomiting, rash,infection, hair loss, infertility, cancer | |
| cyclosporine (Sandimmune, Neoral) | Hypertension, hair growth, tremors, tender or enlarged gums, kidney damage | |
| mycophenolate mofetil (Cellcept) | Diarrhea, nausea |
Chart courtesy of John H. Klippel, M.D.
Updated by Robert S. Katz, M.D.