As treatment for lupus has improved over time, rheumatologists have come to realize that long-term risks that lupus patients face include cardiovascular disease as well as potential side effects from medication treatment. If you have lupus, and your condition is under good control, 2 long-term issues that you must consider with your physician are the following:
#1 cardiovascular disease risk: Lupus patients are at higher risk for heart disease. This is a well known risk in lupus patients for the last several years. A recent study now also documents lupus patients are also at higher risk for cardiovascular events around the time of surgery. While lupus is an independent risk factor for cardiovascular disease, you should also attempt to minimize other cardiovascular risk factors, including high blood pressure, high cholesterol, inactivity, and poor dietary habits. This is an essential part of treating lupus patients long term.
#2 if your condition is under good control, you should try to minimize medications that may put you at risk for other complications. For many lupus patients they require some disease modifying treatment long-term to keep their condition under control. This is appropriate, and with appropriate monitoring can be done safely. However, if a lupus patient is requiring significant doses of prednisone long-term, and the condition is under control, that individual should strongly consider using an alternative medication to minimize their prednisone dosage. Over months to years chronic significant doses of prednisone, even if given intermittently, can be dangerous. Risks for infections, osteoporosis, diabetes, high blood pressure, and also heart disease, are increased with chronic prednisone usage. An essential aspect of treating lupus patients long-term is to minimize their life long exposure to prednisone.
Overall, as treatment for lupus has improved and our understanding of the condition has advanced over the years, rheumatologists need to be extremely concerned about the long-term issues lupus patients are facing. The most pressing issues include cardiovascular disease risk as well as risk of overuse of steroids.