Atypical infections during combination therapy with anifrolumab and other immunosuppressives in patients with lupus erythematosus: A case series

作者：Shae Chambers, Laís Lopes Almeida Gomes, Xiwei Yang, Aretha On, Hammad Ali, Touraj Khosravi‐Hafshejani, Kimberly DeQuattro, Preethi Thomas, Victoria P. Werth · 发表于：JDDG Journal der Deutschen Dermatologischen Gesellschaft · 年份：2025 · DOI：10.1111/ddg.15790 · 被引用次数：1 · 研究领域：Systemic Lupus Erythematosus Research、Immunodeficiency and Autoimmune Disorders、Chronic Lymphocytic Leukemia Research

Dear Editors, Systemic lupus erythematosus (SLE) is a chronic autoimmune disease that can be life-threatening. Anifrolumab is a type I interferon (IFN) receptor inhibiting IgG1κ monoclonal antibody administered intravenously every 4 weeks and indicated in the treatment of adults with moderate to severe SLE.1 The type I IFN receptor is a key part of the body's defense against viruses, fungi, and bacteria. Its blockade dampens the immune response, making it harder for the body to fight off infections, and making infection a notable side effect of anifrolumab use.2-4 We conducted a retrospective chart review of 144 patients seen at the Hospital of the University of Pennsylvania who received anifrolumab treatment between January 2021 and October 2024, and identified 14 patients who experienced an atypical infection, three of which were severe. Of the 14 patients identified, all were female, with a median age of 42.5 years. The time from anifrolumab initiation to adverse reaction ranged from 1 week to 20 months, with a median of 7 months. Upper respiratory infection (URI), bronchitis, and herpes zoster, which occurred in eight of the cases, are commonly known infections associated with anifrolumab use (Table 1).3, 4 Here, we highlight three cases with atypical adverse reactions. Patient 1 is a 22-year-old female with a history of SLE and discoid lupus erythematosus (DLE). She was taking 100 mg azathioprine daily for 3 years and mycophenolate mofetil (MMF) 2,000 mg daily for 2 year...