From the Guidelines
Lupus is indeed an inflammatory process, characterized by widespread inflammation throughout the body, resulting from an autoimmune response that mistakenly attacks healthy tissues and organs. Systemic lupus erythematosus (SLE) is a multisystem disease that can affect multiple body systems, including the skin, joints, kidneys, brain, heart, lungs, and blood vessels [ 1 ]. The inflammatory process in lupus occurs due to the production of autoantibodies that target the body's own cells and tissues, particularly nuclear components like DNA, leading to immune complex formation, complement activation, and cytokine production [ 1 ]. This results in tissue damage and classic inflammatory symptoms of lupus, such as joint pain, skin rashes, fever, and fatigue.
The treatment of lupus aims to reduce inflammation and suppress the abnormal immune response, with anti-inflammatory and immunosuppressive medications like corticosteroids (prednisone), hydroxychloroquine, methotrexate, and biologics like belimumab being the mainstay of treatment [ 1 ]. The goal of treatment is to achieve long-term patient survival, prevent organ damage, and optimize health-related quality of life [ 1 ].
Key aspects of lupus management include:
- Multidisciplinary care based on shared patient-physician decision-making
- Consideration of individual, medical, and societal costs
- Initial high-intensity immunosuppressive therapy to control disease activity, followed by less intensive therapy to consolidate response and prevent relapses
- Use of hydroxychloroquine, glucocorticoids, and immunomodulatory agents to minimize disease activity and prevent flares [ 1 ].
Overall, the inflammatory nature of lupus is well-established, and treatment strategies focus on reducing inflammation and suppressing the abnormal immune response to achieve optimal patient outcomes.
From the FDA Drug Label
The mechanisms underlying the anti-inflammatory and immunomodulatory effects of hydroxychloroquine sulfate in the treatment of rheumatoid arthritis, chronic discoid lupus erythematosus and systemic lupus erythematosus are not fully known.
Lupus is associated with inflammatory processes, as indicated by the use of anti-inflammatory medications such as hydroxychloroquine sulfate in its treatment. However, the exact mechanisms of these effects are not fully understood 2, 2.
From the Research
Definition and Pathogenesis of Lupus
- Lupus, also known as systemic lupus erythematosus (SLE), is a chronic autoimmune disease that can affect various organs and tissues in the body 3.
- The disease is characterized by a complex interplay of genetic predisposition, environmental triggers, and hormonal factors, leading to the production of autoantibodies and immunocomplexes that cause tissue damage and inflammation 3.
Inflammatory Process in Lupus
- The pathogenesis of lupus involves multiple cellular components of the innate and immune systems, including the engagement of the complement system and the dysregulation of cytokines such as type I interferons 3.
- The disease is marked by the presence of autoantibodies and immunocomplexes, which can deposit in tissues and cause inflammation and damage 3, 4.
- The inflammatory process in lupus can affect various organs, including the skin, joints, kidneys, heart, and brain, leading to a wide range of clinical manifestations 3, 4.
Treatment and Management of Lupus
- The treatment of lupus typically involves the use of immunomodulators and immunosuppressants to reduce inflammation and prevent tissue damage 3, 5.
- Mycophenolate mofetil (MMF) is a commonly used immunosuppressant for the treatment of lupus nephritis, which is a common and potentially life-threatening complication of the disease 6, 7, 5.
- The use of MMF and other immunosuppressants can help to reduce the risk of renal failure and other complications of lupus, and improve the overall quality of life for patients with the disease 6, 7, 5.