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Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice

Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterised by unpredictable flares. Many patients with SLE are unable to achieve the recommended treatment goal of remission or the intermediate, yet still clinically beneficial, goal of Lupus Low Disease Activity State (LLD...

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Autor principal: Tanaka, Yoshiya
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BMJ Publishing Group 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441065/
https://www.ncbi.nlm.nih.gov/pubmed/37597847
http://dx.doi.org/10.1136/rmdopen-2023-003270
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author Tanaka, Yoshiya
author_facet Tanaka, Yoshiya
author_sort Tanaka, Yoshiya
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description Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterised by unpredictable flares. Many patients with SLE are unable to achieve the recommended treatment goal of remission or the intermediate, yet still clinically beneficial, goal of Lupus Low Disease Activity State (LLDAS) with standard of care (SoC) treatments. LLDAS is an emerging treat-to-target goal in SLE with the aim of reducing organ damage and mortality. A high unmet need remains in SLE and mainstay glucocorticoid treatment is associated with unacceptable toxicity. The recently approved type I interferon receptor antagonist anifrolumab is a new treatment option for this historically underserved patient population. In phase 3 trials, a higher percentage of patients on anifrolumab achieved remission, as defined by the Definition Of Remission In SLE (DORIS), and LLDAS compared with placebo. Real-world clinical experience with anifrolumab use is still limited. Until real-world study results and updated treatment guidelines are available, personal expert clinical experience supported by data may inform clinical decision-making. This viewpoint article discusses four example patient types that could be considered for anifrolumab treatment based on (1) high-risk features early in the disease course, (2) inability to achieve and (3) maintain at least LLDAS, or (4) a desire to reduce or stop SoC. These patients with high unmet need may benefit from the addition of anifrolumab to SoC to achieve or maintain the therapeutic goals of LLDAS or DORIS remission.
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spelling pubmed-104410652023-08-22 Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice Tanaka, Yoshiya RMD Open Lupus Systemic lupus erythematosus (SLE) is a heterogeneous autoimmune disease characterised by unpredictable flares. Many patients with SLE are unable to achieve the recommended treatment goal of remission or the intermediate, yet still clinically beneficial, goal of Lupus Low Disease Activity State (LLDAS) with standard of care (SoC) treatments. LLDAS is an emerging treat-to-target goal in SLE with the aim of reducing organ damage and mortality. A high unmet need remains in SLE and mainstay glucocorticoid treatment is associated with unacceptable toxicity. The recently approved type I interferon receptor antagonist anifrolumab is a new treatment option for this historically underserved patient population. In phase 3 trials, a higher percentage of patients on anifrolumab achieved remission, as defined by the Definition Of Remission In SLE (DORIS), and LLDAS compared with placebo. Real-world clinical experience with anifrolumab use is still limited. Until real-world study results and updated treatment guidelines are available, personal expert clinical experience supported by data may inform clinical decision-making. This viewpoint article discusses four example patient types that could be considered for anifrolumab treatment based on (1) high-risk features early in the disease course, (2) inability to achieve and (3) maintain at least LLDAS, or (4) a desire to reduce or stop SoC. These patients with high unmet need may benefit from the addition of anifrolumab to SoC to achieve or maintain the therapeutic goals of LLDAS or DORIS remission. BMJ Publishing Group 2023-08-18 /pmc/articles/PMC10441065/ /pubmed/37597847 http://dx.doi.org/10.1136/rmdopen-2023-003270 Text en © Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited, appropriate credit is given, any changes made indicated, and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) .
spellingShingle Lupus
Tanaka, Yoshiya
Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice
title Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice
title_full Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice
title_fullStr Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice
title_full_unstemmed Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice
title_short Viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice
title_sort viewpoint on anifrolumab in patients with systemic lupus erythematosus and a high unmet need in clinical practice
topic Lupus
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10441065/
https://www.ncbi.nlm.nih.gov/pubmed/37597847
http://dx.doi.org/10.1136/rmdopen-2023-003270
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