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Other Drugs
In addition to these commonly used
classes of medications, there are a
number of other medications used,
often experimentally, to treat lupus.
These include thalidomide and
dehydroepiandrosterone (DHEA).
- Thalidomide is a notorious sleep
aid that was pulled from the
market in European countries
when people discovered it
caused birth defects. However,
it is showing effectiveness as a
treatment for skin manifestations
of lupus.
Although its precise mechanism
is not clear, thalidomide inhibits
inflammatory cytokines in
the skin and underlying blood
vessels.
Thalidomide carries the risk
of many side effects, including
abdominal pain, infection, chills,
diarrhea, liver abnormalities,
anemia, peripheral edema,
hyperlipidemia, leukopenia,
insomnia, sensory neuropathy,
albuminuria, hematuria, ovarian
failure, and thrombosis.
Because of the risk of
birth defects, it is strictly
contraindicated in women who
are pregnant or might become
pregnant. Scientists are working
on developing a safer version of
thalidomide. A number of other
drugs are used to treat specific
manifestations of lupus.
- DHEA (dehydroepiandrosterone) is a weak male hormone
used by the body to make other
hormones, including testosterone
and estrogen. It appears to
benefit women with lupus by
helping to restore the balance of
male-female hormones.
The manufacturer of the DHEA
product Prestara® recently
completed a phase III clinical
trial to determine if DHEA
improves bone mineral density
in women with lupus who are
receiving corticosteroid therapy.
There was a modest change
at 1 year. An earlier study of
the drug confirmed Prestara®'s
ability to improve or stabilize
clinical outcome and disease
symptoms in women with mildto-
moderate lupus.
The FDA did not approve
DHEA for treating lupus. In
the meantime, patients may
get DHEA from a compounding
pharmacist. If you have patients
using DHEA, it is important
to stress that they purchase
a medical-grade product from
a pharmacy and have regular
check-ups to monitor response to
the drug.
DHEA is never used in men
with lupus. In postmenopausal
women, mammograms and PAP
smears must be monitored.
Source: National Institutes of Health, U.S.Dept of Health and Human Services
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