CellCept® (Mycophenolate Mofetil)
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Lupus treatment includes care for symptoms as they arise, plus treatments aimed at slowing down the overall course of the disease, such as anti-inflammatories, steroids, and immunosuppressants. Every lupus patient should also have their Vitamin D status regularly monitored, and optimized. (Also see Autoimmune Diseases and Overview of Lupus)
Lupus Treatment Currently, there is no cure for lupus. But treatments can ease symptoms and reduce complications. Mayo Clinic
Comparative Rates of Serious Infections Among Patients With Systemic Lupus Erythematosus (SLE) Receiving Immunosuppressive Medications. In a nationwide longitudinal study of Medicaid SLE patients at high risk of infection, rates of serious infection and mortality did not differ among new users of mycophenolate mofetil, azathioprine, or cyclophosphamide. PubMed, Arthritis Rheumatol, 2017 Feb;69(2):387-397.
Risk of high–grade cervical dysplasia and cervical cancer in women with systemic lupus erythematosus (SLE) receiving immunosuppressive drugs. Among women with SLE, immunosuppressive drugs may be associated with a greater, albeit not statistically significant, risk of high–grade cervical dysplasia and cervical cancer compared to patients receiving hydroxychloroquine alone. PubMed, Lupus, 10/31/2016. (Also see Immunosuppressants and Cancer)
Illness perception in systemic lupus erythematosus (SLE) patients: The roles of alexithymia and depression. Studying the role of psychological factors, may contribute to a more comprehensive perspective of SLE, including their impact on patients' beliefs about treatment effectiveness and emotional adaptation to chronic disease. Comprehensive Psychiatry, 09/30/2015. (Also see Depression)
Prolonged Clinical Remission in Patients with Systemic Lupus Erythematosus. Prolonged remission is an infrequent outcome among patients and is preceded by an atypically monophasic clinical course in a significant minority and may reflect unique pathophysiologic mechanisms. PubMed, J Rheumatol, 2014 Aug 1.
How is systemic lupus treated? There is no permanent cure for systemic lupus. The goal of treatment is to relieve symptoms and protect organs by decreasing inflammation and/or the level of autoimmune activity in the body. Many patients with mild symptoms may need no treatment or only intermittent courses of antiinflammatory medications. MedicineNet
Angiotensin-converting enzyme inhibitors (ACE) delay the occurrence of renal involvement and are associated with a decreased risk of disease activity in patients with systemic lupus erythematosus (SLE)—results from LUMINA (LIX): a multiethnic US cohort. ACE inhibitor use delays the development of renal involvement and associates with a decreased risk of disease activity in SLE. S. Durán-Barragán. Rheumatology Advance Access.
Supervised physical exercise improves endothelial function in patients with systemic lupus erythematosus. Physical exercise is a useful strategy to improve endothelial function and aerobic capacity without worsening disease activity in SLE patients. Rheumatology.
Hydroxychloroquine (HCQ) as an anti–thrombotic in antiphospholipid syndrome. The mechanisms of action of HCQ, and clinical and experimental data in systemic lupus erythematosus (SLE) and APS are discussed. PubMed, Autoimmun Rev, 2015 Apr;14(4):358-62. (Also see Antiphospholipid and Antimalarials)
Anti-Malarials in the Treatment of Lupus. Anti-malarials are particularly effective in treating skin and joint symptoms that may occur in SLE. They have been demonstrated to improve muscle and joint pain; inflammation of the lining of the heart (pericarditis); inflammation of the lining of the lung (pleuritis); and other symptoms of lupus such as fatigue and fever. Lupus Foundation of America.
Effect of mycophenolate mofetil on the white blood cell count and the frequency of infection in systemic lupus erythematosus. Leukopenia does not worsen with mycophenolate mofetil, which appears to slightly increase the rate of bacterial (but not viral) infection. PubMed, Rheumatol Int, 04/03/2015.
Mycophenolate mofetil (MMF) is as efficacious as, but safer than, cyclophosphamide (CYC) in the treatment of proliferative lupus nephritis: a meta-analysis and meta-regression. MMF offers similar efficacy in renal remission and survival as CYC, and appears safer in the treatment of proliferative lupus nephritis. A. Mak. Rheumatology Advance Access. June 3 2009. (Also see Lupus Symptoms)
Cyclophosphamide (generic) was also formerly known by the brand name Cytoxan.
Effect of corticosteroids and cyclophosphamide on sex hormone profiles in male patients with Systemic Lupus Erythematosus (SLE) and Systemic Sclerosis (SSc). Our study highlights the negative impact of corticosteroids on the gonadal function in male SLE and the use of cyclophosphamide during the year prior to inclusion impaired bioactive testosterone levels in SLE and SSc. PubMed, Arthritis Rheumatol, 01/31/2017.
Diet and Nutrition. In general, you should try to eat a nutritious, well-balanced, and varied diet that contains plenty of fresh fruits and vegetables, whole grains, moderate amounts of meats, poultry, and oily fish, as fish oil has been found to help reduce inflammation. Lupus Foundation.
Methotrexate (MTX) in systemic lupus erythematosus (SLE). The use of MTX is associated with significant reductions in SLE Disease Activity Index and the average dose of corticosteroids in adult patients with SLE. PubMed, Lupus, 2014 Jan 7. (Also see Methotrexate)
Periodontitis treatment improves systemic lupus erythematosus response to immunosuppressive therapy. Periodontal disease treatment seems to have a beneficial effect in controlling disease activity in SLE patients under immunosuppressive therapy and therefore, management of this modifiable risk factor is recommended. PubMed, Clin Rheumatol, 2014 Jan 11. (Also see Immunosuppressants)
Glucocorticoids and irreversible damage in patients with systemic lupus erythematosus (SLE). Prednisone causes damage in SLE, but doses less than 7.5 mg/day and methylprednisolone pulses are not associated with damage accrual. PubMed, Rheumatology (Oxford), 2014 Mar 27. (Also see Glucocorticoids, Steroids (Prednisone) Warnings)
Prednisone in lupus nephritis: How much is enough? A combination of medium-dose prednisone, methylprednisolone pulses, cyclophosphamide and hydroxychloroquine is at least as effective in achieving remission of lupus nephritis as regimes containing high-dose prednisone and causes less toxicity. ScienceDirect. Autoimmunity Reviews Volume 13, Issue 2, February 2014, Pages 206–214.
Lupus nephritis and B–cell targeting therapy. The combination of different targeted approaches as well as a focus on new clinical end–points may be strategies to identify new therapeutic options. PubMed, Expert Rev Clin Immunol, 08/11/2017. (Also see B Cells and T Cells)
Predicting and managing primary and secondary non-response to rituximab using B-cell biomarkers in systemic lupus erythematosus. Treatment with anti–CD20 agents can be guided by B-cell monitoring and should aim to achieve complete depletion. PubMed, Ann Rheum Dis, 07/06/2017. (Also see B Cells and T Cells)
Rituximab usage in systemic lupus erythematosus (SLE)–associated antiphospholipid syndrome (APS): A single–center experience. In this single–center study there were no recurrent thrombotic events after the rituximab therapy, implicating further consideration of large–scale trials to evaluate its therapeutic role in SLE–associated APS patients. PubMed, Semin Arthritis Rheum, 2016 Aug;46(1):102-8. (Also see Antiphospholipid Syndrome)
Tacrolimus (TAC) use in lupus nephritis: A systematic review and meta–analysis. In moderately severe lupus nephritis, there is some evidence supporting efficacy of TAC or multi–target TAC+ mycophenolate (MMF) over IV cyclophosphamide, but no evidence supporting TAC over MMF. PubMed, Autoimmun Rev, 09/29/2015.
Sleep disorders in systemic lupus erythematosus (SLE). Does vitamin D play a role? A role for vitamin D in sleep quality of SLE patients was found and further studies are warranted to confirm these results and to find possible mechanisms of action. PubMed, Lupus, 2014 Apr 14.
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