SYSTEMIC LUPUS ERYTHEMATOSUS (SLE)-MANAGEMENT

SUMMARY

1. Stress exacerbates SLE. Avoid surgery during active disease, encourage sunscreen protection, avoid cigarette smoking

2. Start with NSAIDs for joint disease.

3. Hydroxychloroquine for treating skin rashes and arthritis, and to prevent disease flares.

4. Use high-dose glucocorticoids only for patients with severe disease and major organ involvement.

5. Low-dose maintenance corticosteroids is required to control symptoms and prevent flares. Up to 1/3 of SLE patients on chronic high-dose glucocorticoids develop AVN of the hip/knee/humerus.

6. Cytotoxics (azathioprine, mycophenolate mofetil, or cyclophosphamide) are added to corticosteroids for serious flares, particularly renal and CNS disease.

7. Anti-B-cell drugs (rituximab and belimumab) are occasionally used in patients with disease that is refractory to corticosteroids.

Reference(s)

Wilkinson, I., Furmedge, D. and Sinharay, R. (2017). Oxford handbook of clinical medicine. Oxford: Oxford University Press. Get it on Amazon.
Feather, A., Randall, D. and Waterhouse, M. (2020). Kumar And Clark’s Clinical Medicine. 10th ed. S.L.: Elsevier Health Sciences. Get it on Amazon.
Hannaman, R. A., Bullock, L., Hatchell, C. A., & Yoffe, M. (2016). Internal medicine review core curriculum, 2017-2018. CO Springs, CO: MedStudy.
Therapeutic Guidelines. Melbourne: Therapeutic Guidelines Limited. https://www.tg.org.au [Accessed 2021].