Lupus
Understanding Lupus: Causes and Treatment Options
Lupus is a chronic autoimmune disease in which the immune system—normally responsible for defending against infections—mistakenly attacks the body’s own healthy tissues. This misfire is known as autoimmunity or loss of self-tolerance, and it leads to widespread inflammation throughout the body.
What Causes Lupus?
While the exact cause remains unknown, lupus likely results from a combination of contributing factors:
Genetics: Certain people have a genetic predisposition to lupus.
Environmental triggers: Infections, sunlight, and some medications may activate the disease.
Hormonal factors: Estrogen is thought to play a role, which may explain why lupus more often affects women of childbearing age.
Impaired immune clearance: Some individuals may struggle to eliminate damaged cells properly, which fuels a chronic immune response.
Lupus can affect people of all ages, but it most often begins between ages 15 and 45. It tends to be more common—and sometimes more severe—in individuals of Black, Asian, or Hispanic descent. When lupus begins in childhood, it's referred to as childhood-onset SLE (cSLE), which affects about 20% of those diagnosed and can require more intensive care.
How Is Lupus Treated?
Though there’s no cure, lupus is treatable. The goal is to calm the immune response, relieve symptoms, protect organs, and ultimately prevent long-term damage. Treatment plans are individualized and may include the following:
First-Line Therapy
Hydroxychloroquine (Plaquenil) – An antimalarial recommended for nearly all lupus patients. It helps with joint pain, skin rashes, fatigue, and prevents disease flares.
Immunosuppressive Medications
Used when symptoms are more severe or affect major organs (e.g., kidneys, lungs, brain).
Corticosteroids (e.g., prednisone)
Immunosuppressants such as:
Azathioprine (Imuran)
Mycophenolate mofetil (Cellcept)
Methotrexate
Cyclophosphamide (Cytoxan)
Rituximab (Rituxan)
Pain & Symptom Management
NSAIDs such as ibuprofen or naproxen may be used for inflammation and joint pain.
Biologic Therapy
Belimumab (Benlysta) is an FDA-approved biologic used for mild to moderate lupus in both adults and children. It works by targeting specific pathways in the immune system to reduce disease activity.
Important Considerations
Medication side effects—particularly from corticosteroids—should be carefully monitored. Side effects may include weight gain, mood changes, bone thinning, or increased risk of infection.
Ongoing communication with your healthcare team is essential for safely adjusting therapy as needed.
Treatment of childhood-onset lupus (cSLE) requires a multidisciplinary approach—including pharmacists, physicians, social workers, and therapists—to support both physical and emotional well-being.
✅ Lupus (SLE) Patient Treatment Checklist
Initial Assessment & Planning:
[ ] Confirm lupus diagnosis and disease activity level with your rheumatologist
[ ] Review organ involvement (kidneys, lungs, brain, etc.) through lab and imaging tests
[ ] Discuss treatment goals: reduce flares, protect organs, improve daily function
[ ] Create a personalized care plan, including medication and monitoring schedule
[ ] Connect with your care team: pharmacy, rheumatology, mental health, nutrition, and support resources
Medication Management:
[ ] Start hydroxychloroquine (Plaquenil) unless contraindicated
[ ] Take corticosteroids (e.g., prednisone) exactly as prescribed—discuss tapering plans when possible
[ ] Begin immunosuppressants (e.g., methotrexate, Cellcept, azathioprine, Rituxan) if needed for organ involvement
[ ] Ask about biologic therapy (e.g., belimumab/Benlysta) if you meet eligibility
[ ] Track side effects (e.g., weight changes, infections, mood shifts) and discuss with your provider
[ ] Schedule lab monitoring for medication safety (CBC, liver/kidney function, etc.)
Self-Care & Lifestyle Support:
[ ] Protect against sun exposure with SPF 30+ and sun-safe clothing
[ ] Prioritize balanced meals rich in calcium, vitamin D, and antioxidants
[ ] Incorporate gentle physical activity or stretching as tolerated
[ ] Get enough rest and pace yourself to prevent fatigue
[ ] Seek emotional support through counseling, group therapy, or online lupus communities
Ongoing Monitoring:
[ ] Keep routine appointments with your rheumatologist and care team
[ ] Monitor symptoms—note new rashes, fevers, joint pain, or swelling
[ ] Update your care team if you're planning pregnancy or experiencing changes in health
[ ] Carry a medication list and emergency contact card at all times
[ ] Reassess your treatment plan every 3–6 months or as needed