The University of Toledo Translation Journal of Medical Sciences 
Rheumatology Abstract, Department of Medicine Research Symposium UTJMS 2023 May 05; 11(1):e1-e2 

Safety and Efficacy of Anifrolumab in Systemic Lupus 
Erythematosus: Systematic Review with Network Meta-
analysis 
Rawish Fatima1*, Muhammad Aziz, MD2, Yasmin Khader3, Wade Lee-Smith4, 
Nezam Altorok, MD1

1Division of Rheumatology, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
2Division of Gastroenterology, Diabetes, and Metabolism, Department of Medicine, 
The University of Toledo, Toledo, OH 43614 
3Division of Internal Medicine, Department of Medicine, The University of Toledo, 
Toledo, OH 43614 
4Department of University Libraries, College of University Libraries, The University 
of Toledo, Toledo, OH 43614 

*Corresponding author: rawish.fatima@utoledo.edu

Published: 05 May 2023 

Introduction: Enhanced cold sensitivity is an early and consistent phenomenon in scleroderma (SSc). 
Introduction: Anifrolumab is a human monoclonal antibody targeting type 1 interferon receptor subunit 
1 for treatment of systemic lupus erythematosus (SLE) with varying results. We performed a systematic 
review and network meta-analysis comparing varying doses of Anifrolumab versus placebo for 
treatment of SLE. 

Methods: A comprehensive search of different databases was undertaken through May 31, 2022. The 
primary outcome was British Isles Lupus Assessment Group (BILAG)–based Composite Lupus 
Assessment (BICLA) score at 52 weeks. Secondary outcomes assessed included overall flares at 52 
weeks, adverse events and serious adverse events. Network meta-analysis was conducted using random 
effects model and frequentist approach.   

Results: A total of 3 RCTs with 4 unique intervention arms were included (Placebo, Anifrolumab 
150mg, Anifrolumab 300mg, and Anifrolumab 1000 mg). A total of 1129 patients were randomized, of 
which 953 (84.4%) completed the study. The mean age of patient was 41.2 ± 1.3 years and female 
proportion was 1045/1129 (92.5%). Significantly higher ‘BICLA response’ was noted for Anifrolumab 
300mg compared to placebo (RR: 1.61, CI: 1.30-1.99) (Figure 1A). The overall ‘flares’ were also 
significantly lower for Anifrolumab 300mg compared to placebo (RR: 0.76, CI: 0.65-0.90) (Figure 1B). 
The adverse events were evaluated by 4 groups. Significantly higher ‘any adverse events’ were noted for 
Anifrolumab 300mg (RR: 1.10, CI: 1.04-1.16) and Anifrolumab 1000mg (RR: 1.14, CI: 1.02-1.26) 
(Figure 1C). None of the groups of Anifrolumab showed significantly higher adverse events compared 
to Placebo (Figure 1D). Using the P-score, Anifrolumab 300mg was ranked higher for improved BICLA 

https://dx.doi.org/10.46570/utjms.vol11-2023-278 

https://dx.doi.org/10.46570/utjms.vol11-2023-278
mailto:rawish.fatima@utoledo.edu


https://dx.doi.org/10.46570/utjms.vol11-2023-278 UTJMS 11(1):e1-e2 

https://dx.doi.org/10.46570/utjms.vol11-2023-278 2 ©2023 UTJMS 

response and lower flares, while the placebo group ranked higher for lower overall and serious adverse 
events. 

Conclusion: Anifrolumab 300mg showed significantly better response at 52 weeks and lower overall 
flare events for SLE. The drug can be employed in clinical practice for SLE patients. 

https://dx.doi.org/10.46570/utjms.vol11-2023-278
https://dx.doi.org/10.46570/utjms.vol11-2023-278