– Milagros, Minneapolis
A: In general, remission means that all or most symptoms of lupus are gone and objective tests (usually bloodwork) are normal. Your rheumatologist may use a disease activity score, such as the Systemic Lupus Erythematosus Disease Activity Index (SLEDAI) to determine whether you are in remission. You can find the SLEDAI form via a Google search and calculate your score with your doctor.
In practice, it is sometimes difficult to define remission because many symptoms of lupus may also be seen in other health conditions, or may be related to your medications. One example is fatigue. Even when lupus is under excellent control, fatigue sometimes does not go away and may continue to affect your quality of life. Working closely with your rheumatologist will help identify the best ways to tackle these types of symptoms.
Achieving remission requires treatment. If untreated, lupus typically does not go into remission, and even gets worse over time. With modern therapies, however, the vast majority of patients can achieve remission, even when lupus is severe.
The key is to have a productive relationship with your rheumatologist who will help determine which medications are right for you. It often takes months to come up with an effective and safe regimen, and further adjustment is needed as your disease (and your life) changes, and as new medications become available. To maximize your chances of achieving remission, always remember to take your medications, communicate with your doctor, and take care of yourself. Staying fit, eating healthy, and wearing sunscreen can go a long way!
About the Doctor
Dr. Anna Shmagel is an assistant professor of medicine in the Division of Rheumatic and Autoimmune Diseases at the University of Minnesota. Her interests in rheumatology include treating systemic lupus erythematosus (SLE), vasculitis, osteoarthritis, and chronic pain. Before pursuing training to become a rheumatologist, Dr. Shmagel was a teaching hospitalist for NorthShore University Healthcare System in Chicago, Illinois, and was a clinical educator at the University of Chicago Pritzker School of Medicine.