Anifrolumab
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Dosing and administration
For active, autoantibody-positive SLE as add-on to standard therapy. Available intravenously and subcutaneously. Not recommended in severe active lupus nephritis or severe active CNS lupus, or in combination with other biologics.
| Indication | Starting dose | Titration and maximum |
|---|---|---|
| Systemic lupus erythematosus (IV) | 300 mg IV infusion over 30 minutes, every 4 weeks. | Continue as maintenance; reassess response. |
| Systemic lupus erythematosus (subcutaneous) | 120 mg subcutaneously once weekly. | Continue as maintenance; reassess response. |
Clinical notes
How it is used in lupus
An IFNAR1 antagonist added to standard therapy in active, autoantibody-positive SLE to reduce disease activity and flares. Not recommended in severe active lupus nephritis or severe active CNS lupus, and not for use with other biologics.[1]
Common side effects
Common: upper respiratory tract infection, bronchitis, herpes zoster (6.1% vs 1.3% placebo), oral herpes, and infusion-related reactions (9.4%).[1]
Before starting
Do not initiate with a clinically significant active infection until it resolves. Complete age-appropriate immunizations before starting and avoid live or attenuated vaccines during treatment. Use caution with chronic or recurrent infection or infection risk factors.[1]
Monitoring
Monitor for infections (including herpes zoster) and for hypersensitivity or infusion-related reactions. The effect on malignancy risk for an immunomodulator of this class is not established.[1]
References
- SAPHNELO (anifrolumab) Product Monograph. AstraZeneca Canada Inc. Health Canada; 2026-03-05. https://pdf.hres.ca/dpd_pm/00083796.PDF