Hormones are useful, but not overly dependent Many patients are very reluctant to use hormones, especially some young girls. They worry that long-term use of hormones will make them fat and ugly, and will lead to osteoporosis and femoral head necrosis. Hormones are the basic drugs for treating lupus erythematosus, but the effect of hormones is mainly anti-inflammatory and relieves the inflammation in the acute stage. Therefore, the dose of hormone depends on the intensity of inflammatory reaction. Those with intense inflammatory response are based on hormones mainly. Those with predominantly proliferative and fibrotic lesions are based on immunosuppression. According to this idea, the hormone dose for a specific patient is determined individually. In the treatment of lupus erythematosus, hormone is only an anti-inflammatory drug, and immunosuppressant is the palliative drug. Therefore, the treatment of lupus erythematosus should not rely excessively on hormones, but should be based on immunosuppressants. Treatment, just effective is not enough Even for very severe lupus erythematosus, with the use of hormones, some patients will achieve efficacy, and some patients can even achieve complete remission. If immunosuppressants are added, the probability of complete remission is even higher. Patients who are not on immunosuppressants have a higher rate of relapse during the drug reduction process. With immunosuppressants, the disease will be more stable and less likely to fluctuate. Therefore, the treatment of lupus erythematosus should not be satisfied with “effective”, but should pursue “better” efficacy under the premise of drug safety – to make the disease less prone to relapse and less prone to fluctuation after remission. The disease is less likely to come back and fluctuate after remission. According to Prof. Yang, a concept of target treatment should be established for lupus erythematosus, and the goal of treatment is complete remission of the disease. Some diseases are so stubborn that no matter how to adjust the medication, it is difficult to achieve complete remission, then we should control the disease to low activity as much as possible, so that no damage to the organs will occur and the patient’s life will not be endangered. To achieve the goal of “complete remission”, induction therapy (also called attainment therapy) is used, which is the safest, most effective and cheapest way to make the disease gradually improve toward the treatment goal. The lowest dose of medication (even as low as “zero medication”) is used to keep the disease at the target state and not to progress further. Professor Yang asks lupus patients to have regular follow-ups and lifelong follow-ups. This is because critical lupus patients need to be evaluated and their treatment plan adjusted at any time. Severely ill lupus erythematosus patients need to be reviewed for all clinical and laboratory indicators within a short period of time. Patients who are initially discharged from the hospital and initially treated in outpatient clinics usually need to be re-evaluated every 1-2 weeks for the first month and monthly thereafter. After the disease is controlled to a low level of activity, follow-up assessments will be performed every 3 months. After remission, reassessment can be done every 3 to 6 months.