Successful treatment of severe systemic lupus erythematosus with anifrolumab: a single-center observational study

Introduction This study evaluated the efficacy and safety of anifrolumab (ANF) in patients with systemic lupus erythematosus (SLE) presenting with severe manifestations such as neuropsychiatric SLE (neuro-SLE), lupus nephritis, and antiphospholipid syndrome-associated SLE (APS-SLE), based on real-world clinical practice at a single center in Poland. This study is a retrospective analysis of patients with severe SLE who failed to achieve remission following previous immunosuppressive treatment and were subsequently started on ANF therapy. Material and methods Ten patients with SLE were treated at the Rheumatology Clinic of the National Institute of Geriatric, Rheumatology and Rehabilitation (Warsaw, Poland) between 15 March 2024 and 20 April 2025. Data collected included medical history, clinical and demographic information, imaging results, Systemic Lupus Erythematosus Disease Activity Index 2000 (SLEDAI-2K) score, and treatment details. All patients had severe forms of SLE, with some presenting active neuropsy­chiatric symptoms and others with active lupus nephritis. All were unresponsive to prior high-dose immunosuppressive therapy and glucocorticosteroids. Results All 10 patients with severe manifestations, including neuro-SLE, lupus nephritis and APS-SLE, showed significant clinical improvement following ANF therapy, as evidence by reduced SLEDAI-2K scores. Conclusions Anifrolumab appears to be a promising and safe therapeutic option for patients with severe SLE based on real-world data.