Treatment and Health Maintenance
Current research in SLE treatment includes studying ways to:
- Optimize the use of immunosuppressive drugs such as corticosteroids and cyclophosphamide in people with lupus while decreasing unwanted side effects
- Develop new therapies with fewer side effects
- Correct underlying immune abnormalities
- Improve the reproductive health of women with lupus
- Evaluate the safety of hormone replacement therapy for women with lupus
Other areas of research include the identification of combination therapies that may be more effective than single-treatment approaches; using novel biologic agents to selectively block parts of the immune system, examining the benefits associated with dehydroepiandrosterone (DHEA) therapy, a naturally occurring hormone present in unusually low concentrations in women with lupus; chemotherapy to work selectively on the immune system, and the role of nitric oxide in inflammatory disease in humans.
Researchers are looking at ways to correct underlying immune abnormalities in people with lupus by exploring the dimensions, risks, and benefits of reconstructing the immune system by high-dose cyclophosphamide with or without stem cell rescue.
Investigators have long considered that hormones may influence lupus and work is underway in the area of reproductive health, the use of oral contraceptives and estrogen replacement therapy. The SELENA study (Safety of Estrogen in Lupus Erythematosus National Assessment) will hopefully yield options for safe, effective methods of contraception for young women with lupus as well as options for estrogen replacement therapy for postmenopausal women with lupus.
In the area of reproductive outcomes for women with lupus, doctors can anticipate and prepare to treat babies born with neonatal heart block, the most serious complication of neonatal lupus. And research now allows doctors to predict the likelihood of a lupus-related miscarriage and take measures to prevent miscarriage, as well as identify women at risk for giving birth to babies with neonatal lupus.
Lupus Registry and Repository
The National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS) of the NIH has established a lupus registry and repository. Researchers studying families in which two or more members have been diagnosed with lupus collect and update clinical, demographic and laboratory data on these individuals and submit the data to the registry. A centralized database will maintain genetic information and clinical and laboratory information. The registry and repository will allow researchers to perform genetic analysis, which may lead to identifying lupus genes, developing new treatments, and identifying which patients develop the most severe manifestations of lupus.
Adapted primarily from "Lupus: A Patient Care Guide for Nurses and Other Health Professionals" (NIAMS).