REAL-WORLD OUTCOMES OF ANIFROLUMAB IN SYSTEMIC LUPUS ERYTHEMATOSUS PATIENTS AT THE TORONTO LUPUS PROGRAM
Bibliographic record
Abstract
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.
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.003 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".