Your treatment choices for lupus depend on how severe your symptoms are, whether your organs are affected, and how much your symptoms affect your daily life.

Treatment for mild lupus may include:

• Corticosteroid cream for rashes.
• Nonsteroidal anti-inflammatory drugs (NSAIDs). These can treat mild joint or muscle pain and fever.
• Antimalarial medicines. They can treat fatigue, joint and muscle pain, and skin rashes.
• Corticosteroid pills. They're used if other medicines don't control your symptoms.

If lupus is affecting your organs, is life-threatening, or is seriously impacting your quality of life, you may also need to take:

• Corticosteroids in higher doses. These may be in pills or through a vein in your arm (IV).
• Medicine that suppresses your immune system (immunosuppressants).

If you get serious kidney disease that can't be controlled with medicine, you may need dialysis or a kidney transplant.

Checking for possible organ damage

As part of ongoing treatment for lupus, you may have a:

• Urinalysis. This test checks for protein and cells, signs of possible kidney problems.
• Kidney biopsy, if your doctor sees signs of kidney inflammation. This test may help your doctor find the best treatment for you. Only a small number of people with lupus need a kidney biopsy.

To look for other possible causes of symptoms, imaging tests are sometimes done, depending on which organ systems are involved. These tests include CT scan, echocardiogram, MRI, and X-rays.

What to think about

Lupus treatment is complicated by several things. The course and pattern of lupus symptoms vary widely. Flares and remissions can occur at any time. They make it hard to tell how you are responding to treatment or which treatments are most helpful. Some treatment side effects can be as troubling as the symptoms of lupus.

You may not be able to completely get rid of all of your symptoms for long periods of time, especially without the side effects from medicines. Work closely with your doctor to reach a balance between reasonably controlling your symptoms, preventing damage to your organs, and having fewer side effects of long-term drug treatment. For example, you may take a dose of medicine that will control lupus enough to prevent organ damage. But you may still have symptoms such as mild skin rash, muscle aches, and joint pain.