What medications are used to treat lupus erythematosus?

Commonly used medications for systemic lupus erythematosus (SLE) fall into the following major categories:

First, antimalarial drugs—such as chloroquine and hydroxychloroquine—which are effective across all SLE subtypes and help reduce disease relapse. They are typically used in combination with glucocorticoids.

Second, glucocorticoids. These are the first-line treatment for patients with moderate disease severity and significantly improve survival. They are also indicated for patients with renal involvement or neuropsychiatric manifestations; dosage is adjusted according to disease activity. Prednisone is commonly initiated at 0.5–1 mg/kg/day; once disease control is achieved, the dose is gradually tapered to a maintenance dose of 10–15 mg/day. High-dose pulse therapy is reserved for severe manifestations, including lupus encephalopathy, lupus nephritis, and severe hemolytic anemia.

Third, immunosuppressants. Commonly used agents include cyclophosphamide, azathioprine, and methotrexate. These may be combined with glucocorticoids during steroid tapering or employed specifically in patients with lupus nephritis.

Fourth, other therapeutic options, such as thalidomide or high-dose intravenous immunoglobulin (IVIG) pulse therapy.