By: Howard Smith, MD
For several decades, the medicines available to treat lupus stayed pretty much the same. In recent years, however, we’ve seen a breakthrough with targeted therapies — medicines that are directed at one little molecule in the immune system.
The most significant new treatments
Doctors like me who treat lupus hope that these newer drugs will have fewer side effects and be more effective.
Here is a quick overview of these therapies:
Belimumab, which is given intravenously, works on knocking out the white blood cells, called B lymphocytes, which make antibodies. It hasn’t been shown to be an effective treatment for lupus patients with kidney disease. But if you do not have kidney problems, you may see some benefit.
Rituximab has been used in rheumatoid arthritis patients with good results, and it’s being studied for use in patients with lupus as well. It also knocks out B lymphocytes that produce antibodies. Lupus is a disease where trying to knock down the production of antibodies is important.
Thalidomide and lenalidomide, which work on the immune system, are showing some promising effects on lupus that affects the skin. They have approval from the Food and Drug Administration for other conditions, but are being used off-label and in clinical trials for lupus patients. Part of the appeal is that these medications are taken as a pill rather than an injection, unlike similar drugs for joint problems.
Tofacitnib, which has been shown to slow joint damage, was recently approved for use in rheumatoid arthritis patients. There’s hope that it will help lupus patients as well.
Belimumab currently has approval from the Food and Drug Administration (FDA) for treatment of lupus. The others are FDA-approved for other conditions, but not lupus, and are being studied for their effectiveness in lupus patients.
If other treatments haven’t worked for you, you can talk to your doctor about using the medication off-label or taking part in a clinical trial.
