Anifrolumab is used in addition to standard therapy (oral corticosteroids and/or immunosuppressants and/or antimalarials) for the treatment of adult patients with active, autoantibody positive, systemic lupus erythematosus (SLE). It works by blocking the action of a group of proteins called Type I Interferons (IFN) by binding to a portion of the type I interferon receptor (IFNAR1) thereby decreasing the biologic activity of type I IFNs. Since it affects the immune system, it can also increase the risk of infections.
Anifrolumab is a biologics medication used in addition to standard therapy (oral corticosteroids and/or immunosuppressants and/or antimalarials) for the treatment of adult patients with active, autoantibody positive, systemic lupus erythematosus (SLE).
It works by blocking the action of a group of proteins called Type I Interferons (IFN) by binding to a portion of the type I interferon receptor (IFNAR1) with high specificity and affinity. This binding inhibits type I IFN signalling thereby blocking the biologic activity of type I IFNs. Type I Interferons are found at high levels in people with lupus and blocking them can reduce the inflammation in your body that causes the signs and symptoms of lupus. Anifrolumab may help to reduce your lupus disease activity and the number of lupus flares you are experiencing.
Like all of the biologics, you will not feel the effects of anifrolumab right away. Some people begin to feel the effects of anifrolumab within a few weeks; however, it may take three to six months to feel the full effect. It is important to be patient and keep taking your medication. Improvements in skin symptoms may be seen in two months and it may take longer before the dose of corticosteroids (e.g., prednisone) may be decreased without worsening symptoms.
Taking anifrolumab can make it more difficult for your body to fight infections. Therefore, people with active infections should not take this medication. If you have a fever, think you may have an infection or have been prescribed an antibiotic, contact your healthcare provider. People who have had frequent infections in the past or a history of tuberculosis should discuss the use of anifrolumab with their healthcare provider.
Also contact your healthcare provider if you are having surgery as you may need to stop anifrolumab until you are healed and there is no sign of infection.
Anifrolumab has not been studied in pregnant people or lactating parents so its effect(s) on pregnant people or nursing babies are unknown. You should tell your doctor if you are pregnant or are planning to become pregnant. Because of the potential for adverse reactions in nursing infants, a decision should be made with your healthcare provider on whether or not to discontinue nursing or the medication, taking into account the importance of the drug to the lactating parent.
Those who have had a previous allergic reaction to anifrolumab should avoid the medication.
People with a history of cancer should discuss the use of anifrolumab with their healthcare provider.
Before starting this medication, you will likely be tested for inactive (“latent”) tuberculosis (TB) and hepatitis B because abatacept can dampen the immune system and cause these infections to become active. If TB or hepatitis is found, it will need to be treated before you start anifrolumab.
Make sure that your vaccinations are up to date before starting anifrolumab. Your healthcare provider will likely recommend a number of vaccines (e.g., influenzae, pneumonia, RSV, shingles) to get beforehand. Because anifrolumab can decrease your ability to respond to vaccines, you should wait at least two to three weeks after your last vaccine before starting anifrolumab. If you are already on anifrolumab and need a vaccination, talk to your healthcare provider about vaccine spacing and whether or not you need to hold anifrolumab. Live vaccines are not recommended due to risk of causing infection. Before receiving any vaccinations while taking anifrolumab, you should speak with your healthcare provider.
Like all medications, taking anifrolumab carries some risk of side effects, which must be balanced with the potential benefits. In general, the risk of joint damage and permanent disability (resulting from arthritis) is much greater than the risks of side effects from anifrolumab. When monitored properly the vast majority of side effects are rare, most improve over time and are reversible.
Infusion-related reactions occur during the infusion and are mild or moderate in intensity, the most common symptoms were headache, nausea, vomiting, fatigue, and dizziness.
As with all DMARD and biologic medications, anifrolumab can lower the ability of your immune system to fight infections and increase your risk of infections. You should take precautions to minimize your risk of being infected by common contagious infections such as COVID-19, influenzae, pneumonia, and the common cold.
The most commonly reported side effect with anifrolumab is joint pain, or pain in arms or legs as well as symptoms of a cold (sore throat, stuffy nose). Infusion reactions with anifrolumab can occur including reaction (redness, pain, and itching) at the injection site. Other commonly reported symptoms include eczema and oral thrush. Talk to your healthcare provider if any of these symptoms affect you severely.
When monitored properly, the vast majority of side effects are rare, most improve over time and are reversible.
Anifrolumab can increase your risk of infections. You should take precautions to minimize your risk of being infected by common contagious infections such as COVID-19, influenzae, pneumonia, and the common cold.
Anifrolumab can in rare cases cause an allergic reaction during the infusion (flushing, itching, changes in heart rate and blood pressure, etc.). A healthcare professional will monitor for this reaction during the infusion.
In rare cases, people experience neck pain, weakness and fatigue. If this becomes severe, please consult your healthcare provider.
Before starting this medication, you will likely be tested for inactive (“latent”) tuberculosis (TB) and hepatitis B because anifrolumab can dampen the immune system and cause these infections to become active. If TB or hepatitis is found, it will need to be treated before you start anifrolumab.
Rarely anifrolumab can cause a serious allergic reaction (feeling faint, swelling of the face, eyelids, tongue, lips, mouth or throat, trouble breathing, chest tightness). If you have troublesome symptoms talk to your healthcare provider.
Take anifrolumab as prescribed and contact your healthcare provider if you have any concerns while taking the medication.
If you experience an infusion reaction while taking anifrolumab, prior to your next infusion your healthcare provider may recommend a medication pre-treatment to prevent this. Your prescriber may also recommend a longer infusion time.
Keeping yourself well hydrated before getting your infusion and drinking while you get your infusion may also help reduce side effects.
Contributors
This information was last updated in June 2024 with expert review and advice by:
Alan Low, BSc(Pharm), PharmD, ACPR, FCSHP, CCD, RPh
Clinical Professor, Faculty of Pharmaceutical Sciences, University of British Columbia
Pharmacy Lead and Primary Care Pharmacist, BioPro Biologics Pharmacy
Care Director, MedInfuse Health
Garrett Tang, PharmD, RPh
Pharmacist Services Coordinator, MedInfuse Health
We also thank previous expert contributor:
Jason Kielly, BSc(Pharm), PharmD
Assistant Professor, School of Pharmacy, Memorial University of Newfoundland
Clinical Pharmacist, Rheumatic Health Program, Eastern Health
