Lupus (Systemic Lupus Erythematosus) - Other Treatment

Other Treatment

While some people with lupus (systemic lupus erythematosus, or SLE) try alternative or complementary therapies (such as special diets, fish oils, or chiropractic treatment), these are not proven treatments for lupus.

Some therapies that focus on relaxation can help you cope with having a long-lasting (chronic) disease and may significantly improve your quality of life. These relaxation therapies include:

• Massage.
• Yoga.
• Guided imagery.

Experimental therapies for lupus

Medications and therapies currently under investigation are meant to alter immune system function, thus preventing the disease from progressing. These newer treatments include stem cell transplantation and biologic treatment.

Immunoablation with or without stem cell transplantation is being studied as a treatment for severe lupus. Immunoablation uses powerful drugs to wipe out the damaged immune system. After immunoablation, either the bone marrow is allowed to replace itself, or it is partially replaced through a stem cell transplant. The transplant replaces damaged or destroyed bone marrow cells with healthy cells, or stem cells. Stem cells are immature cells that are produced in the bone marrow. They can divide to produce more stem cells or mature into red blood cells, white blood cells, and platelets. More study of these treatments for lupus is needed.¹⁶

Biologic treatment blocks specific steps in the lupus autoimmune process without suppressing the entire immune system. Researchers are currently experimenting with very specific substances, such as antibodies and nucleotides, that block the earliest steps of the autoimmune process.¹⁶ Studies have tested several biologic agents in the last few years.¹⁷ Examples of these substances are CTLA-4, anti-C5B, and CD154.⁶ Another biologic substance under study, LJP-394, has shown some effectiveness in reducing lupus disease activity.¹⁷Rituximab is an antibody directed against certain immune cells that may have a role in lupus. It is approved for treating rheumatoid arthritis. Studies are looking at the use of rituximab for lupus.¹⁰ It is beginning to be used for lupus flares that have not responded to other immunosuppressive therapies. In some cases, rituximab has been associated with serious side effects such as breathing difficulty, heart problems, or severe infection. So, the use of rituximab is closely watched.

DHEA (also called prasterone in the United States) is an androgenic dietary supplement that is derived from the wild yam. Experts suggest only using pharmaceutical-grade (versus "natural") DHEA. Results of research are mixed but suggest that DHEA may lessen the need for corticosteroids and improve bone density, as well as reduce symptoms for people with lupus.¹⁷ One study suggested that disease activity decreased or became stable for some women with mild-to-moderate lupus treated with DHEA.¹⁸ The most common side effects of DHEA are acne and facial hair growth in women and hair loss in men. Because this supplement is a hormonal substance, consult your doctor before using it, and have your DHEA blood levels checked every 6 months.

Plasmapheresis, the removal of some parts of the blood, is rarely used as treatment for lupus except for severe cases in which other treatments are not effective. Studies continue on plasmapheresis as treatment for lupus; some studies show benefit while others show no benefit.^{17, 16}

Intravenous immune globulin (IVIG) may be used to treat lupus that is associated with destruction of blood platelets.¹⁹