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The following are possible treatments that could be used to treat
Lupus in the future. None are currently approved as treatments for
lupus.
DHEA
Dehydroepiandrosterone (DHEA)
The first new drug for mild to moderate lupus to be developed
in some time is on the fast track. Dehydroepiandrosterone (DHEA)
is an old drug with potentially important antilupus properties.
A natural body substance made by the adrenal gland, DHEA has been
available for more than 50 years and is not regulated by the Food
and Drug Administration. DHEA is a hormone with male-like properties.
Investigators have been interested in male hormones (androgens)
because in animal studies they tend to decrease the immune response
while female hormones (such as estrogen) tend to amplify it.
DHEA has additional effects that may have widespread implications.
In animal models and human studies it has demonstrated potential
to decrease obesity, reduce lipid levels, slow or halt osteoporosis,
improve cognitive functioning, and increase levels of an important
cytokine known as interleukin-2. Levels of DHEA decrease with age,
and lupus patients at any age have less DHEA than one might expect.
Several hundred lupus patients have been given the drug in trials,
and preliminary evidence suggests that it has anti-inflammatory
effects in mild and moderate lupus and can steroid-sparing as well
as being well tolerated with antimalarials. The therapeutic dose
appears to be in the 50 mg to 200 mg range.
Even though it is premature to make any conclusive statements
about DHEA, this hormone is a promising therapy that may be useful
for lupus patients with non-organ threatening disease who do not
have a complete response to nonsteroidal anti-inflammatory drugs,
antimalarials or low dose steroids. It could possibly commercially
available in a reliable form in 2-3 years.
What are the side effects of DHEA?
The major side effects encountered thus far include acne and facial
hair growth. Some patients have reported headaches, irritability
and fluid retention. The drug appears to be well tolerated and is
currently being studied in a multicenter, double-blind study that
our center has participated in.
"I am not sure that DHEA is complimentary or whether it is
considered a suppiment, but it has worked for me. My physician started
me on 200 mg of DHEA a day and I am currently taking 300 mg. I started
it because of the Brainfog. It has kept me on an even keel. If I
don't take the DHEA I can tell the difference and so can the people
around me. I will audio the beginning and ending of sentences but
forget the middles. I can tell that I am not doing well, I get "those"
looks from family and friends. :-) I have not had any side effects,
but I am currently taking steroids and Imuran. How can anything
else give me more side effects?? DHEA is NOT a fountain of youth,
but it gave my brain a boost that I really needed." Chris
Cox
LJP394
What is LJP394?
It is a new drug undergoing trials, to evaluate the potential
to prevent renal flares; reduce disease severity, the need for immunosuppressive
steroids/chemotherapy drugs and hospitalization; and improve patients'
quality of life.
LJP 394 is designed to tolerize or shut down pathogenic B cells,
arresting their production of antibodies to double-stranded DNA
(dsDNA). Antibodies to dsDNA are widely believed to be responsible
for lupus nephritis (kidney disease), a principal cause of morbidity
and death in lupus patients.
A double-blind placebo controlled trial using patients with mild
lupus symptoms explored the activity of LJP 394 using varying dosages
and frequencies of administration. The drug was well tolerated with
no clinically significant dose related adverse reactions observed.
In patients receiving weekly 10 or 50 mg doses of LJP 394, antibodies
to dsDNA were reduced and remained suppressed for up to two months
after the last dose.
LJP (La Jolla Pharmaceuticals) scientists have designed
LJP 394 to specifically arrest the production of dsDNA antibodies
without compromising the protective functions of the immune system.
More info on LJP394...
Danazol
Is marketed for the treatment of endometriosis. It is an
anti-oestrogen hormone, which has been fond can improve autoimmune
hemolytic anaemia & low platelet counts associated with SLE.
Bromocriptine
Inhibits the secretion of breast milk by blocking the actions
of prolactin, the hormone that stimulates the production of breast
milk. Considerable evidence has accumulated indicating that
many lupus patients have elevated prolactin levels. This,
in turn, is associated with an immune dysfunction.
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