Systemic Lupus Erythematosus - Treatment for Cutaneous and Mild SLE

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Investigational Alternatives to NSAIDs

NO-NSAIDS. Experimental drugs are being developed that combine nitric oxide with NSAIDs (NO-NSAIDs). Nitric oxide increases blood flow in the mucous lining and secretions of mucus and bicarbonate.

Antimalarial Drugs

Antimalarial drugs may be prescribed for discoid lupus (skin sores) or for mild lupus when skin problems and joint pains are the predominant symptoms:

• Hydroxychloroquine (Plaquenil) is the most common antimalarial drug used for lupus. This drug is effective as maintenance therapy to reduce flares in patients with mild or inactive disease. Hydroxychloroquine may help protect against blood clots in people with antiphospholipid syndrome, high cholesterol levels, and bone loss.
• Other antimalarial drugs include chloroquine (Aralen) or quinacrine (Atabrine).

High doses may be prescribed initially in order to accumulate high levels of the drug in the blood stream. It is not known exactly why antimalarials work. Some researchers believe they inhibit the immune response, and others think they interfere specifically with inflammation.

A 2006 study suggested that anti-malarial drugs work best in patients who have genetic predispositions to certain types of immune-fighting proteins. The study found that patients who had genetic variations causing abnormally high levels of tumor necrosis alpha (TNF-alpha) and abnormally low levels of interleukin-10 (IL-10) responded best to these drugs.