ANIFROLUMAB markedly reduced disease activity and let patients cut back steroids in a real-world cohort with systemic lupus erythematosus, a 12-month study reports, while also dampening the interferon-driven immune signals that fuel the disease.
An Interferon-Targeted Option in Lupus
Type I interferon signalling is a core driver of systemic lupus erythematosus (SLE), and anifrolumab, which blocks that pathway, has shown efficacy and steroid-sparing effects in trials. Yet prospective real-world evidence on its long-term effectiveness, safety, and immunological effects, especially on neutrophils and interferon mediators, has remained limited.
Study Design and Immune Monitoring
The longitudinal, multicentre, observational cohort enrolled 20 adults with active SLE receiving intravenous anifrolumab 300 mg every four weeks, excluding those with active lupus nephritis or central nervous system disease. Clinical and laboratory measures were recorded at baseline and at months 3, 6, 9, and 12, alongside chemokines, cytokines, low-density neutrophils (LDNs), and neutrophil extracellular trap degradation products. Baseline mean SLEDAI-2K disease activity was 10.9, with frequent musculoskeletal, immunological, and skin involvement. Longitudinal changes were modelled with generalised additive models, and drug persistence at 12 months was the practical marker of continuation.
Sustained Disease Control and Steroid Tapering
Over 12 months, mean SLEDAI-2K fell to 3.1 (95% CI 1.1 to 5.1; p<0.001), while Physician Global Assessment improved from 1.6 to 0.2 (95% CI 0.0 to 0.5; p<0.001). An SLE Responder Index-4 response was reached by 64.7% at month 12, with 86% attaining Lupus Low Disease Activity State and 50% meeting remission criteria. Daily prednisolone equivalents dropped significantly (p=0.036), with 11 of 13 glucocorticoid users reaching 5 mg/day or less, three stopping entirely. Anifrolumab significantly reduced circulating LDNs (p=0.032) and interferon-driven mediators. Drug persistence was 65%, with 55 adverse events, four serious.
Guiding Use in Interferon-Driven Disease
The authors concluded that anifrolumab delivered marked, sustained improvements in disease activity, enabled glucocorticoid tapering, and reduced low-density neutrophils and interferon-driven chemokines in active systemic lupus erythematosus, with safety and persistence matching trial data. They noted clinical gains occurred without shifts in anti-double-stranded DNA or complement, fitting the drug’s interferon-targeted rather than B-cell mechanism. Because the cohort was small and uncontrolled, they framed the mechanistic findings as a guide to patient selection and future biomarker research rather than definitive proof.
Reference
Temiz A et al. Real-world longitudinal assessment of anifrolumab in patients with systemic lupus erythematosus: clinical outcomes, safety and modulation of cytokines and neutrophil activity. RMD Open. 2026;12:e006806.
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