Surgery

Surgery isn't used to treat mild or moderate symptoms of lupus. But it may be considered for people who have permanent, life-threatening kidney damage. A kidney transplant or kidney dialysis may be done instead of continuing long-term treatment with high doses of medicines that have serious side effects.

Other Treatment

While some people with lupus 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 yoga, guided imagery, and massage.

Experimental therapies for lupus

Medicines and therapies now being studied are meant to change how the immune system works, so that they can keep 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 that has not been controlled with all other treatments. 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 they can mature into red blood cells, white blood cells, and platelets. More study of these treatments for lupus is needed.

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. Examples of these substances are CTLA-4, anti-C5B, CD154, and LJP-394. Rituximab 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. 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 most studies show the drug has no more impact on the lupus itself than a placebo.⁴ 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, talk to your doctor before using it. And have your DHEA blood levels checked every 6 months. Long-term effects are not known.

Plasmapheresis, the removal of some parts of the blood, is rarely used as treatment for lupus except for certain severe cases in which other treatments are not effective.⁵

Intravenous gamma globulin (IgG) may be used to treat lupus that has not responded to other treatment. There is not good evidence that this works for lupus.