Lupus

What is lupus?

Lupus is an autoimmune disease where your body’s immune system attacks different parts of your body. It is called the disease of “many faces” because lupus can look very different for different people. The most common symptoms include a typical race on sun exposed areas, such as the face, Raynaud’s phenomenon (hands/feet turning white, blue, then red triggered by cold or stress), and joint swelling. Sometimes, lupus can cause organ damage and affect the kidneys (lupus nephritis), heart (pericarditis) or lungs (pleuritis).

RheumInfo Lupus:

https://rheuminfo.com/en/diseases/systemic-lupus-erythematosus/

Lupus Canada:

https://www.lupuscanada.org/

How is lupus treated?

The first line treatment for lupus is hydroxychloroquine. Hydroxychloroquine is recommended for all patients with lupus. It helps with rash, joint swelling, reduces flares, reduces organ damage, lower lipid levels, reduces the risk of blood clots and increases survival. Typically, there are no side effects with hydroxychloroquine. It does require annual eye checks

RheumInfo Hydroxychloroquine: https://rheuminfo.com/en/medications/plaquenil/

What other treatment is available?

If someone has active lupus despite hydroxychloroquine, other medications may need to be tried. The medication selected depends on the symptoms. Other options include methotrexate, azathioprine, mycophenolate mofetil, cyclophosphamide and rituximab.

There are newer medications, called biologics, that have promise in lupus. These are not yet covered by BC Pharmacare, but may be covered for patients with extended benefits. This includes medications like belimumab.

What can I do to help my lupus?

  1. Exercise. Regular aerobic exercise and strength training is helpful. Often times, people with lupus have fatigue and fibromyalgia. This improves with regular, graduated exercise.
  2. Sun protection. UV damages DNA and can cause lupus to flare. I recommend using a sunscreen with SPF > 50 with UVA-A and UV-B. Look for a sunscreen without para-aminobenzoic acid (PABA) because this can make you more sensitive to the sun. Avoid being outside during peak UV-B (10am-4pm).
  3. Smoking. If you smoke, you should talk to your primary care practitioner or pharmacist about methods for quitting. Smoking can make lupus skin lesions more difficult to treat.
  4. Diet. There is no high or moderate quality evidence to recommend a specific diet for lupus. There is some evidence for calcium and vitamin D supplementation, omega-3 supplementation angreen tea extract (improved fatigue).