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Objectives To evaluate real-world effectiveness, safety, and steroid-sparing potential of anifrolumab in patients with systemic lupus erythematosus (SLE) treated at a tertiary referral center in Denmark.Methods All consecutive SLE patients treated with anifrolumab between May 2022 and February 2025 were included. Clinical data were retrieved from electronic records. Disease activity was assessed by SLEDAI-2K, Physician’s Global Assessment (PGA), Lupus Low Disease Activity State (LLDAS), and DORIS remission.Results Thirty-six patients (n = 36) (94% female, mean age 52 ± 17 years, mean disease duration 14 years) received anifrolumab for a mean duration of 462 days. Forty-four percent were biologic-naïve; 31% had prior belimumab, and 28% rituximab exposure. Most patients had moderate-to-high baseline disease activity (median SLEDAI 8 [range 2–20]).Disease activity declined rapidly after initiation. Median SLEDAI fell from 8 to 2 at month 3 and 0 at month 6 and last follow-up. The proportion with SLEDAI = 0 increased from 0% to 41% at 3 months, 52% at 6 months, and 52% at final follow-up. PGA improved concordantly, with 87% < 0.5 at 6 months.At last follow-up, 83% fulfilled LLDAS and 61% met DORIS remission criteria (figure 1).Corticosteroid exposure was markedly reduced: 58% received prednisolone at baseline vs <30% after 6 months, with mean dose reduction >50% (figure 2). In several cases, flares were managed without reintroducing steroids.Adverse events were mainly mild infections, predominantly herpesvirus-related (4 zoster, 2 HSV). One disseminated herpes infection led to discontinuation; no deaths or new organ damage occurred. Twenty-eight percent had received zoster vaccination prior to initiation.Abstract PO:11:277 Figure 1LLDAS and DORIS remission during treatment with anifrolumabAbstract PO:11:277 Figure 2Prednisone reduction during anifrolumab treatmentConclusions In this real-world Danish cohort, anifrolumab produced substantial and sustained reductions in disease activity and corticosteroid use, with high rates of LLDAS and remission and an acceptable safety profile. Herpesvirus infections were the most frequent adverse events, underscoring the importance of zoster vaccination before initiation. These findings support anifrolumab as an effective, steroid-sparing, and generally well-tolerated therapy for moderate-to-severe SLE in clinical practice, and highlight the importance of pre-treatment zoster vaccination.