Abstract
Objective
Anifrolumab (ANF) has been approved to treat extra-renal manifestations in Systemic Lupus Erythematosus (SLE) patients. Real-life data underline the excellent efficacy in skin involvement, but very little is known on other manifestations. We conducted a prospective longitudinal analysis to assess ANF efficacy in SLE-related joint involvement by using ultrasound.
Methods
We enrolled patients receiving ANF for musculoskeletal manifestations. All the patients were evaluated at baseline (T0) and after 1 (T1) 3 (T3) and 6 (T6) months of treatment.
US assessment was performed at level of bilateral hands MCP and PIP joints. According to the OMERACT, we evaluated the presence of US inflammatory features (synovial effusion/hypertrophy, Power Doppler - pD), measured by semiquantitative score (0–3), resulting in a total US inflammatory score (0–180) and total PD score (0–60).
Results
Our cohort comprised 13 female patients. During the follow-up period, we found a significant reduction of US scores already after 1 month of treatment, with a further significant reduction after 3 and 6 months. Interestingly, after 6 months, 90% of patients showed negativization of pD signal in all the joints. Parallelly, we found a significant improvement in global disease activity indices and in DAS28crp values at all the time-points.
Conclusions
Our analysis, made in a real-life scenario, underlines the fast efficacy of ANF on joint synovitis as shown by the reduction in US scores in the early stages of treatment. The rapid effect on pD signal suggest the ability of this drug to prevent the development of erosive damage.
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