Drug-inducted lupus can be resolved by discontinuing the medication under a physician's supervision, but there is no known cure for other forms of lupus including systemic lupus erythematosus (SLE). Treatment focuses on relieving symptoms, preventing relapses (flares) and avoiding complications such as organ damage. Most patients are able to lead long, fairly normal lives with extended periods of remission disrupted by occasional flares. It is important for patients to receive regular medical care even during remissions.

There are many medications that can help relieve SLE and other forms of lupus. Typically a physician will try milder drugs and use stronger doses or medications if necessary. Medications may include:

• Corticosteroids for inflammation. These may be given by mouth, by injection or in topical creams. Risks of long-term use of corticosteroids include osteoporosis, fractures, diabetes, glaucoma and cataracts.

• Aspirin or other NSAIDs (nonsteroidal anti-inflammatory drugs) for inflammation, fever and pain.
  
  
• Topical creams for rashes.
  
  
• Anti-malaria drugs and chemotherapy drugs. Though originally developed to treat other diseases, these medications can relieve symptoms of SLE.
  
  
• Intravenous immunoglobin (IVIG). This blood product may be used as an anti-inflammatory.
  
  
• DMARDs (disease-modifying antirheumatic drugs). These medications can decrease joint damage, reduce swelling and pain and sometimes slow or halt progression of the disease. Potential side effects include increased risk of infection and gastrointestinal, liver or kidney complications.
  
  
• Other immunosuppressives. Patients with damage to kidneys or other organs may be prescribed drugs that suppress the immune system, including biologic response modifiers (BRMs) such as TNF inhibitors. Potential risks of such medications include infections.

These medications can have strong side effects, but the physician may be able to reduce or discontinue use of the drugs during remissions. Patients should inform their physician of side effects and not discontinue medications on their own. The U.S. National Institutes of Health (NIH) recommends that patients taking corticosteroids or anti-malaria drugs have an annual eye examination to check for eye problems that may result. Patients using corticosteroids long-term are advised to ask about osteoporosis monitoring tests such as a DEXA scan, a type of x-ray.

Clinical trials are being conducted to assess new medications for lupus. Interested patients can ask their physician for details or check the web site of the NIH (www.clinicaltrials.gov).

There is no research showing that alternative treatments (those not part of standard medical care) benefit lupus patients, according to the NIH. Patients should discuss any alternative treatments with their physician before trying them. Herbal supplements and vitamins interact with some medications, and some supplements may contain unsafe ingredients.

Lupus patients often are treated by a rheumatologist or an immunologist (physician who specializes in immune disorders). Other health professionals can also help:

• Specialist physicians. Dermatologists treat the skin conditions, orthopedists the bone and joint complications, nephrologists the kidney disorders, neurologists the nerve disorders, pulmonologists the lung disorders and cardiologists the cardiovascular problems that may result from SLE.
  
  
• Psychologists or psychiatrists. Address depression, anxiety, stress, self-esteem, altered body image and other issues that often arise.
  
  
• Occupational therapists. Offer instruction in energy conservation, work modification, task simplification, assistive devices, posture and ergonomics, relaxation techniques, stress management, and other ways to adapt and avoid fatigue.
  
  
• Physical therapists. Offer exercises to maintain range of motion (ROM) and reduce stiffness, and modalities such as therapeutic ultrasound and thermotherapy to reduce pain and maintain ROM.
  
  
• Dietitians. Can recommend beneficial foods, such as those rich in vitamin K to ease skin conditions and those rich in calcium and vitamin D to strengthen bones.
  
  
• Orthopedic surgeons. Joint surgery is usually the last treatment option for damaged joints.

There is no known way to prevent lupus, but patients can take action to help avoid flares and complications. These steps include:

• Watching for warning signs. Many people with SLE experience symptoms before a flare strikes. These may include fatigue, pain, rashes, fever, abdominal pain, headache or dizziness.
  
  
• Rest. It is important for individuals to conserve energy if a flare is imminent. Setting priorities and delegating tasks to others are essential at times.
  
  
• Limiting exposure to ultraviolet light. Sunlight, tanning beds and other sources of ultraviolet rays can cause lupus to flare. Patients may need supplements of vitamin D, which the skin makes with the help of solar radiation. Some individuals are even sensitive to indoor light and may need dimmer lighting to prevent or relieve flares.
  
  
• Stress management. Meditation, yoga, biofeedback and other techniques often help individuals cope. Some patients find relief in lupus support groups.
  
  
• Exercise. Aerobic, ROM and strengthening exercises, particularly during remissions, can help people endure flares. Patients should get approval from their physician before starting an exercise program. ROM activities may be beneficial during flares, but other exercises may need to be restricted.
  
  
• Nutrition. A healthy diet helps the body cope with flares. The NIH recommends a diet rich in calcium and vitamin D to promote bone health and lower the risk of SLE-related osteoporosis and fractures.

Because SLE raises the risk of atherosclerosis and cardiovascular disease, patients should take preventive measures such as controlling blood pressure and cholesterol and not smoking, according to the American College of Rheumatology. Patients should also be screened regularly for kidney disease and have it treated promptly and aggressively.

Patients at increased risk for blood clots (e.g., blood testing reveals antiphospholipid antibodies) should not take estrogen, the American College of Rheumatology recommends.

Lupus may affect many aspects of a person's life, but being proactive can empower individuals physically and psychologically.