4 replies to this topic

[rwac]

Antimalarials Recommended for All Lupus Patients
Anthony J. Brown, MD
January 22, 2010 —

Use of antimalarial agents can improve survival
with systemic lupus erythematosus and should be given to all patients
with the disease, according to a report in the January 7th issue of Arthritis
& Rheumatism.

During a median follow-up period of 55 months, the mortality rate for
non-users of antimalarial drugs was 11.5%, while that of users was just
4.4% (p < 0.001). Further analysis showed that patients who used the
drugs for more than 2 years had the lowest mortality per 1000
person-years of follow-up — 0.54 deaths, compared to 3.07 in non-users.

Prior research has suggested that antimalarial therapy can help
prevent flare-ups of lupus and reduce overall damage from the disease,
Dr. Bernardo A. Pons-Estel, from Hospital Provincial de Rosario,
Argentina and co-researchers note.

"The beneficial effects of antimalarials in lupus, however, go beyond
disease activity and damage accrual," the authors state. As an example,
they cite a study in Caucasian patients in which antimalarials seemed
"to have a protective effect on survival" with "a reduction in
mortality." Of note, none of the subjects in the study died from
cardiovascular causes, the most common cause of death in untreated
patients, they add.

Is someone finally getting a clue ?

http://www.medscape....warticle/715655
PS: it might be behind a registration wall.

Edited by rwac, 02 February 2010 - 04:34 PM.

[James Cain]

Makes sense to me. Lupus = autoimmune disease. (Some) antimalarial drugs are immune suppressants. Provided you balance it just right you'd gain the benefits from avoiding Lupus outcomes while not overly compromising your immune system.

My mom who has lupus is on said anti-malarial drugs and has been for years. Do most doctors not do this?

[rwac]

Have you considered the possibility that it works because there's a parasitic infection that the anti-malarial is attacking ?

Antibiotics help most autoimmune diseases too.

[James Cain]

Have you considered the possibility that it works because there's a parasitic infection that the anti-malarial is attacking ?

Antibiotics help most autoimmune diseases too.

Parasitic (or any source of) infections have been linked with development of autoimmune disorders, along with heart disease, metabolic syndrome, Alheimer's, etc. I think the infection hypothesis may be valid for some autoimmune conditions, but not as a major player. Regardless of my opinions there, once the infection would result in autoimmunity, that pathology would be a permanent feature even if the infection/parasite/whatever were to pass. Antibiotics would not help parasitic infection, but would help bacterial infection.

Unless used as a preventative measure (not practical), using antibiotics to treat autoimmune diseases would not treat the underlying dysfunction itself (altered immune function), but could possibly treat some of the symptoms of the autoimmune condition, or even symptoms of other conditions that overlap with the autoimmune profile. For example, immune function is both influenced by and influences gut microbiota, so if for any reason (autoimmune disorder or any other cause such as diet) you have compromised gut bacteria then taking an antibiotic would mostly wipe them out. This is definitely not a good thing in a healthy individual, but in diseased populations it may have more benefit than harm.

The only reasonable autoimmune treatments with current medical technology is to limit progression (anti-immune drugs) and treat symptoms (antibiotics, arthritis meds, etc.). I am most definitely not well read on this subject, but I don't think there's any way to remove immune adaptations once integrated, but any evidence to the contrary would be exciting (and possibly dangerous in practice).

[rwac]

Regardless of my opinions there, once the infection would result in autoimmunity, that pathology would be a permanent feature even if the infection/parasite/whatever were to pass. Antibiotics would not help parasitic infection, but would help bacterial infection.

There is a theory that says differently. The autoimmunity is a consequence of the infection.

http://www.imminst.o...&...st&p=275605

A theory behind autoimmunity that is starting to prevail gives the immune system a little more credit, that it is not retarded enough to randomly attack your own body for no reason. If your genes produced immune systems programmed to self-destruct, they would not have survived the process of evolution. It begins for a legitimate reason (the pursuit of intracellular pathogens) and some confusion ensues among all of the inflammation and immune activity which results in autoantibodies to the tissue that is under fire. These disappear when the pathogen disappears.

Unfortunately, this means that the widespread prescription of immunosuppressant therapies like steroids to patients with autoimmune disorders is probably hastening their demise.