Anifrolumab – a type I interferon inhibitor – a novel treatment for systemic lupus erythematosus
Authors:
M. Olejárová
Authors‘ workplace:
Revmatologický ústav, Revmatologická klinika 1. LF UK, Praha
Published in:
Čes. Revmatol., 32, 2024, No. 1, p. 39-45.
Category:
Úvodník
Overview
Systemic lupus erythematosus (SLE) is a severe systemic autoimmune disease. The standard treatment of SLE involves the administration of glucocorticoids, antimalarials, and synthetic immunosuppressants, but the options for the biological treatment of lupus are still limited. Anifrolumab is historically the second biologic drug registered for the treatment of SLE. It is an IgG1 kappa monoclonal antibody against type I interferon receptor subunit 1 (IFNAR1) that reduces type I interferon (IFN) signaling and subsequent gene expression inducible by these interferons.
Clinical efficacy in active SLE has been evaluated in several randomized, placebo-controlled phase II (MUSE trial) and phase III (TULIP-1, TULIP-2) clinical trials. Reduction in SLE activity, as assessed by BICLA, along with a reduction in glucocorticoids was observed more frequently in TULIP-1 and TULIP-2 trials in patients treated with anifrolumab compared to placebo. The best effect was observed in skin involvement. The effect of anifrolumab was more pronounced in patients with an elevated IFN-I signature before treatment. Anifrolumab also demonstrated efficacy in the treatment of active lupus proliferative nephritis (TULIP-LN), in which the number of patients achieving complete renal remission was higher in patients treated with anifrolumab. The safety of anifrolumab is acceptable, with infections occurring more frequently during treatment, particularly upper respiratory tract infections, and herpes zoster.
Anifrolumab is indicated in the treatment of active SLE, with positive autoantibodies and reduced complement, administered intravenously at a dose of 300 mg every 4 weeks.
Anifrolumab represents an effective alternative to biological therapy for SLE, particularly with cutaneous, hematologic, and potentially renal, involvement. The effect is more pronounced in patients with an elevated type I IFN signature.
Keywords:
biological therapy – anifrolumab – systemic lupus erythematosus
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Dermatology & STDs Paediatric rheumatology RheumatologyArticle was published in
Czech Rheumatology
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