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While there is no way to prevent systemic lupus erythematosus (SLE), there are things you can do to reduce the risk and severity of lupus flares. There are also ways to reduce the potential side effects of medications used to treat the disease.

The first step is exercise. Getting low-impact, aerobic exercise regularly can reduce joint stiffness, lower stress levels and help prevent osteoporosis, weight gain and heart problems that may be caused by medications.

It is also important to determine which environmental factors may trigger your lupus flares. Triggers may include:

• Light. Exposure to the ultraviolet sunlight (and, to a lesser extent, fluorescent and halogen lights) can lead to a skin rash and worsen other lupus symptoms. It helps to wear protective clothing and use sunscreen when outdoors. It is best to use a sunscreen that protects from both UVA and UVB light. Also remember that some UV light penetrates glass, including car windows. Try filters on windows to block UV light.

• Stress. People with lupus often link worsening symptoms or flares to stressful events such as divorce, job change or a death in the family. It is important to recognize that stress did not cause the immune imbalance of lupus and that it is OK to seek help when facing a chronic, and sometimes disabling pattern of symptoms. Try not to underestimate the support you could get from family, friends, health professionals or workplace human resource services. It is equally important not to put your life on hold. Using common sense and getting plenty of rest and exercise is a good antidote to stress. Putting your life on hold and going to bed for the rest of your life is not.

• Overwork or lack of rest

• Infection

• Injuries or surgery

• Pregnancy and childbirth

• Suddenly halting lupus medications

• Sensitivities or allergies to items such as hair dye, hair permanent solution, makeup and skin creams

• Certain over-the-counter medications such as cough syrup or laxatives

• Immunizations

Ongoing Research

Scientists are developing and testing novel biological agents to selectively block parts of the immune system. Some of these new drugs are based on compounds that occur naturally in the body, while others are specifically designed to inhibit key proteins (called cytokines or cell surface signaling proteins) implicated in the inflammatory process. All of these experimental agents comprise an exciting and promising new area of lupus research. Some examples of drugs that are in various stages of development and evaluation include:

• Biologics. The drugs abatacept (Orencia) and rituximab (Rituxan), approved for the treatment of rheumatoid arthritis, are now being studied for the treatment of lupus. In addition, prasterone (Prestara), a synthetic form of dehydroepiandrosterone (DHEA), is being studied as a treatment for steroid-induced osteoporosis in women with lupus, and the drug LJP 394 (Riquent) may be able to block some of the antibodies that are believed to promote kidney disease in people with the disease. The BlyS inhibitor, Lymphostat B, is being studied to see whether it is effective for lupus. This treatment blocks a protein (BLyS) which stimulates B lymphocytes (white blood cells) and might be partially responsible for the excess autoantibodies produced by people with lupus. Another treatment, eculizumab (anti C5a) is being studied for use in cases of lupus where a longer duration of anti-inflammatory activity is necessary.

• Immunosuppressives. Mycophenolate mofetil (CellCept), designed to help prevent organ transplant rejections, is being tested to treat lupus kidney disease that has been unresponsive to other treatments. Cyclosporine (Sandimmune, Neoral) has improved lupus disease activity and reduced corticosteroid dosage in some small studies. Eculizumab (anti C5a) has been shown to be effective in some cases in which a longer period of anti-inflammatory activity is desired. Leflunomide (Arava), a drug for rheumatoid arthritis, may help improve the joint pain, inflammation and stiffness in people with lupus.

These are only a few of the treatments currently in development and study for use in lupus. For a full overview of current clinical trials for lupus see the Web site www.clinicaltrials.gov. Other treatment options being explored include reconstructing the immune system by bone marrow transplantation or autologous stem cell transplantation.

A new research study suggests people with lupus may benefit from a cholesterol-lowering diet. It cannot be stressed too much that healthy eating habits, exercise and a moderate lifestyle are as good for people with lupus as they are for everyone else.