A Retrospective Review of 22 patients on Anifrolumab in Refractory Cutaneous Lupus

Cutaneous lupus erythematosus (CLE) is a heterogeneous disorder that can present alone as cutaneous disease or in conjunction with systemic lupus erythematosus (SLE). Despite CLE often being severe and worsening quality of life, there is still no FDA approved drug for CLE. Anifrolumab, a fully humanized IgG1κ monoclonal antibody, has become a drug of interest because of its significant skin improvement in the SLE trials. We performed a retrospective chart review of a cohort of twenty-four patients initiating anifrolumab infusion therapy from January to November 2022. Twenty-two patients were also identified as having CLE in addition to SLE. Chart review occurred up to August 21, 2023.     Of the twenty-two patients, thirteen (59%) were able to reduce or stop either prednisone or a disease-modifying antirheumatic drug (DMARD). Specifically, eight patients (36%) of the twenty-two completely stopped at least one DMARD. Notably sixteen patients (70%) started anifrolumab on prednisone with eight (50%) being able to discontinue prednisone completely. Seventeen (77%) of the twenty-two had improvement of skin lesions by resolution of rash, no flares since therapy initiation, repigmentation, hair regrowth, or decrease in erythema and scale. Two of the total twenty-four patients reviewed did not have clear evidence of cutaneous lupus although did have cutaneous disease likely related to SLE, therefore were not included in data analysis although are represented in Table 2. The decrease in disease burden, ability to decrease other therapies, and overall tolerability of anifrolumab makes it a promising therapy for those with CLE.