REAL-WORLD OUTCOMES OF ANIFROLUMAB IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS AT THE TORONTO LUPUS PROGRAM
Notice bibliographique
Résumé
PV248 / #665 Poster Topic: AS24 - SLE-Treatment Background/Purpose Anifrolumab (ANI), a human monoclonal antibody targeting the type I interferon receptor subunit 1 (IFNAR1), blocks the activity of this interferon and has shown efficacy in reducing disease activity in systemic lupus erythematosus (SLE). Real-world evidence is critical to understanding its utilization and outcomes. We aimed to describe the profiles of SLE patients treated with anifrolumab for at least 3 months at the Toronto Lupus Program and to evaluate treatment efficacy and safety. Methods We identified patients from the University of Toronto Lupus Cohort who met the European Alliance of Associations for Rheumatology and American College of Rheumatology (EULAR/ACR) 2019 classification criteria and were treated with anifrolumab for at least 3 months. Demographic characteristics, clinical and laboratory variables, previous and concomitant therapy, and disease activity indices (by SLEDAI-2K, BILAG, CLASI and PGA) were evaluated at baseline and during follow-up, as well as time to symptoms response. Prednisone doses, safety outcomes, including infections and treatment discontinuations, were analyzed. Results Seventeen patients (76.5% female, 23.5% male) with a mean age of 40.8 years (SD 12.9) and a mean SLE duration of 14.3 years (SD 11.5) were included. Cumulative preexisting organ involvement at anifrolumab start included mucocutaneous (100%), musculoskeletal (82.4%), serositis (41.2%), hematological (29.4%), renal (23.5%), neuropsychiatric (23.5%) and persistent fever (5.9%). Secondary antiphospholipid syndrome and Sjögren’s syndrome were each observed in 11.8% of patients. The main reasons for initiating anifrolumab included skin rash (n = 14, 82.4%), musculoskeletal involvement (n = 7, 41.2%), alopecia (n = 5, 29.4%), along with the presence of other concomitant hematological involvement (leukopenia) and shrinking lung syndrome. Patients had a mean follow-up duration of 9.4 months (SD 7.4) on anifrolumab. At the initiation of anifrolumab, all patients were on prednisone and 13 patients (76.5%) were receiving hydroxychloroquine. Concomitant immunosuppressive treatments included mycophenolate mofetil in 8 patients (47.1%), methotrexate in 4 patients (23.5%), and a combination of methotrexate and mycophenolate mofetil in 1 patient (5.6%). Prednisone use significantly decreased from a baseline mean dose of 9.4 mg/day (SD 9.25) to 2.5 mg/day (SD 7.5). During treatment, immunosuppressive concomitant therapies were reduced or discontinued in 7 patients (41.2%). SLEDAI-2K scores consistently decreased over time, reflecting significant improvements in disease activity (Figure 1). The median time to 50% improvement in clinical manifestations was 52 days (IQR 34-91), while the median time to total resolution of symptoms was 148 days (IQR 115-233). Anifrolumab was discontinued in 1 patient (5.9%) 20 months after starting treatment to initiate alternate therapy for the development of lupus nephritis during follow-up. Treatment was temporarily held in 1 patient (5.9%) due to refractory molluscum contagiosum occurring after 14 months of therapy; this patient was also on mycophenolate mofetil. No additional adverse events were reported. Overall, the treatment was well tolerated. Figure 1 SLEDAI-2K Scores Over Time. Conclusions Anifrolumab showed significant efficacy in reducing disease activity and prednisone use in SLE patients, with a good overall safety profile.
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,003 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,000 |
| Méta-épidémiologie (sens large) | 0,000 | 0,000 |
| Bibliométrie | 0,001 | 0,001 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,000 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,000 | 0,000 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,000 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».