Sometimes I think about how advanced we are as a society but how we lack in the areas of medications and cures. I don’t know maybe there is a cure in the works that is around the corner. This message from @the_rheumatologist gives a glimpse of hope into the future of medications for lupus and other autoimmune diseases.
Although the treatment of lupus has changed over the years, progress seems slow and inadequate. Many patients still have symptoms even with adequate treatment. With quality of life indices (measured by appropriate scales) similar to patients with severe lung disease and cancer. In fact, the patients with lupus are living longer, but still, they are not living better. And the Rheumatologist often feels he should be doing more for his patient. One way to improve this is the development of new medications. But while we wait them to arrive we beating our brains out to find new ways to use the available drugs.
When we have chance, our new target is the lowest doses of medications, especially corticosteroids. For over 50 years we have basically used the same therapeutic arsenal to treat lupus. Reality quite different from rheumatoid arthritis, for example. In this team are hydroxychloroquine, azathioprine, mycophenolate mofetil and cyclophosphamide that persist as a cornerstone in the treatment of severe lupus and lupus nephritis. Without forgetting the corticosteroids, which despite all undesirable side effects, are the key to the treatment and survival of many cases of the disease. The fully humanized monoclonal antibody against soluble trimeric B cell activating factor (BAFF), belimumab, has been approved for the treatment of lupus in Europe and the USA. But it is indicated for specific cases of the disease. Not being indicated for severe active nephrites or severe active lupus of the central nervous system.
Searching for new drugs to lupus isn’t an easy task since it’s a disease so different in each single patient. Fortunately, the studies persist. And although many don’t reach the expected results sometimes, it’s in our mistakes that we find new paths to follow. Today we have over 500 treatment studies for lupus going on, according to clinicaltrials.gov website. We’ve never had so many studies going on! We look forward and hopeful!