Imuran, Cytoxan And Related Drugs
Although immunosuppressive drugs can have serious side effects, they can be of great value in the treatment of systemic lupus erythematosus (SLE). They may help to:
- prolong life
- preserve kidney function
- reduce disease symptoms
- reduce damage to vital organs, such as the kidneys and lungs.
- sometimes even serve to put the disease into remission.
Steroids used alone to treat major organ involvement in lupus must sometimes be given in high doses. This increases the risk of short-term and long-term side effects, which may sometimes be worse than the disease itself. Immunosuppressive drugs can be used either in addition to, or instead of, steroids to spare the patient some of the undesirable side effects of steroid therapy.
Thus, immunosuppressive and cytotoxic drugs are used in the treatment of lupus for two major reasons:
- They are potent drugs which help to control disease activity in major organs, including the kidney, brain, cardiovascular system, and lungs.
- They may reduce or eliminate the need for steroids (cortisone derivatives such as prednisone).
How Do They Work?
Cells in the body divide and grow at varying rates. Examples of rapidly dividing cells include:
- the antibody-producing cells of the immune system
- blood cells
- hair cells
- gonadal (sex) cells.
Cytotoxic (cyto=cell, toxic=damage) drugs work by targeting these cells which grow at a rapid rate. In lupus, the immune system produces autoantibodies at a rapid rate of growth. Cytotoxic medicines can suppress the cells involved in the hyperactive immune response.
There are risks associated with the use of cytotoxic drugs.
- The immune system may be suppressed too much, which causes an increased susceptibility to infection, particularly shingles (a painful, blistering skin condition) and pneumonia.
- The bone marrow can be suppressed as well, which results in reductions in red blood cells, white blood cells, or clot-forming platelets.
- Suppression of hair cell growth may lead to overall loss of hair.
- The cytotoxic effects on gonadal cells can lead to sterility.