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Objectives Systemic lupus erythematosus (SLE) is a chronic, heterogeneous autoimmune disease with a significant unmet need, particularly in patients with persistent disease activity despite standard therapy. Anifrolumab, a monoclonal antibody targeting the type I interferon receptor, has demonstrated efficacy in randomized clinical trials. However, real-world data from routine clinical practice remain limited.Objectives are to assess the effectiveness and safety of anifrolumab in patients with active SLE treated in routine clinical practice at a tertiary referral center.Methods We conducted a retrospective observational study including SLE patients treated with anifrolumab at the Semmelweis University Department of Rheumatology and Immunology between 2022 and 2024. Demographic data, disease characteristics, organ involvement, SLEDAI-2K scores, glucocorticoid use, and adverse events were evaluated at baseline and during follow-up.Results Eighteen patients were included (16 female), with a mean age of 38.6±11.2 years and a mean disease duration of 9.4±6.1 years. Cutaneous (83%) and musculoskeletal (72%) manifestations were the most common indications for treatment. Mean baseline SLEDAI-2K was 10.8±3.6, decreasing to 5.9±3.1 after 6 months of therapy. Clinical improvement was most evident in skin and joint domains. The mean daily glucocorticoid dose decreased from 12.5±5.4 mg to 6.2±3.8 mg prednisone equivalent, and 61% of patients achieved at least a 50% dose reduction. Mild to moderate adverse events were observed in 33% of patients, mainly upper respiratory tract infections. No treatment-related serious adverse events occurred.Conclusions In this real-world cohort from a tertiary referral centre, anifrolumab was effective and well-tolerated in patients with active SLE. Treatment was associated with significant reductions in disease activity and meaningful glucocorticoid sparing. These findings support the use of anifrolumab in routine clinical practice and are consistent with results from randomised clinical trials.