Chemotherapy is a drug treatment that uses potent chemicals to kill cancer cells or slow their growth. Chemotherapy drugs also suppress the immune system. This makes them useful in treating certain autoimmune diseases, including systemic lupus erythematosus, or lupus.
Lupus is a chronic autoimmune disease in which the immune system mistakenly attacks healthy body cells and tissues, potentially resulting in widespread organ damage.
While chemotherapy may not cure lupus, it can help manage the condition and improve a person’s quality of life.
This article describes the use of chemotherapy drugs as a treatment for lupus, and lists some chemotherapy and other treatments for the condition. It also discusses the prognosis for a person living with lupus.
Lupus is a chronic autoimmune condition that can affect almost any type of body tissue. As such, it has the potential to cause a wide range of symptoms and complications,
- butterfly-shaped facial rash
- abdominal pain
- kidney disease
- blood-related problems, such as anemia and high blood pressure
- inflammation of the surfaces of the heart and lungs
The goal of treatment is to prevent organ damage and achieve remission. The choice of treatment depends on a person’s symptoms and overall health.
Few drugs are available specifically for treating lupus. Treatment options typically include aspirin and prednisone.
However, in 2011, the Food and Drug Administration (FDA) approved belimumab (Benlysta) for treatment of lupus and lupus nephritis. The latter is kidney disease that can occur as a result of lupus.
Doctors do not have many lupus-specific medications, and therefore, they may use chemotherapy drugs to help put lupus into remission.
Chemotherapy drugs are the mainstay of cancer treatment, but they
Doctors may treat lupus with such chemotherapy drugs as:
- methotrexate (Rheumatrex)
- cyclophosphamide (Cytoxan)
- mycophenolate mofetil (CellCept)
As cancer treatments, these medications help slow or stop the growth of cancer cells. However, they do not specifically target cancer cells. Rather, they target rapidly dividing cells, including white blood cells of the immune system.
Chemotherapy interferes with immune cell function. As a result, it can calm autoimmune reactions and reduce inflammation.
Doctors often use immunosuppressant drugs to calm an overactive immune system in individuals with lupus. Some of these medications are also chemotherapy agents.
Methotrexate is an immunosuppressive drug called a disease-modifying antirheumatic drug, as it can decrease joint damage and long-term disability. Methotrexate also belongs to a group of chemotherapy drugs called antimetabolites.
People may take methotrexate as pills or subcutaneous injections, typically as a single dose once weekly. Doctors occasionally prescribe the drug in two doses per week to improve absorption or reduce the risk of side effects.
Methotrexate is not suitable for people with abnormal kidney or liver function, as it can cause scarring of the liver. Consuming alcohol while taking methotrexate significantly increases the risk of liver damage.
Methotrexate can cause gastrointestinal (GI) upset. Rarely, it may cause respiratory symptoms, such as persistent cough or shortness of breath.
Belimumab (Benlysta) is a specific lupus drug that doctors use in combination with other medications, such as hydroxychloroquine and steroids.
Belimumab helps treat mild to moderate lupus that affects the skin, joints, and other organs. It is not a chemotherapy drug.
People may need to attend a clinic for a Belimumab infusion every 2 weeks for the first month, and monthly thereafter.
Alternatively, doctors may prescribe a self-injection form for weekly administration. Symptom relief should occur within 12 weeks, but in some cases, it may take longer.
Side effects of Belimumab are typically mild and include:
People with a history of depression should be aware that Belimumab may cause low mood and thoughts of self-harm.
Mycophenolate mofetil (CellCept) is an immunosuppressant drug that doctors often use to treat people with autoimmune diseases, particularly if kidney disease is present. It is not a chemotherapy drug.
A person takes mycophenolate twice per day and needs to have regular blood tests to check blood counts and liver function.
Side effects of mycophenolate include:
- upset stomach
- sleep problems
- skin rash
Prolonged use of mycophenolate can increase the risk of skin cancer and lymphoma.
Cyclophosphamide (Cytoxan) is a strong immunosuppressant and chemotherapy drug that doctors may prescribe to help put severe lupus into remission.
A person can take cyclophosphamide daily as an oral medication, or they may visit the clinic for a weekly or monthly injection. However, it may take several weeks for symptoms to improve, and several months or more for complete remission.
Doctors may prescribe cyclophosphamide for 3–6 months until a person’s lupus goes into remission. After this, a doctor may prescribe a less potent medication with fewer risks of side effects.
Potential side effects of cyclophosphamide include:
- hair loss
- skin rashes
- increased risk of infections
- problems with the bladder
- bladder cancer
Lupus is a serious chronic condition. Despite medical advancements, doctors need more effective treatments.
According to research, survival rates for lupus are around
Large-scale research into chemotherapy for lupus is lacking, and further studies are necessary to determine the efficacy of these medications.
In general, early diagnosis and treatment could improve a person’s outlook.
Doctors frequently use chemotherapy agents to treat autoimmune diseases. Low doses may help calm an overactive immune system. By contrast, high doses may be necessary to completely suppress the immune system in cases of widespread and severe organ involvement.
Other autoimmune conditions that may benefit from chemotherapy include:
Lupus is a chronic autoimmune disease in which the immune system mistakenly attacks healthy body cells and tissues.
Doctors may use chemotherapy drugs to treat lupus. These medications suppress overactive immune reactions, helping ease inflammation, limit organ damage, and improve quality of life.
Chemotherapy drugs are potent medications that can cause various side effects, including GI upset, muscle aches, and an increased risk of infection.
A person should consult a doctor if they are concerned about chemotherapy side effects.