Anifrolumab Shows Promise in Discoid Lupus Erythematosus: Case Study
USA: A new case reported by researchers in Cureus highlights the potential of anifrolumab as a targeted treatment for discoid lupus erythematosus (DLE) and supports the need for larger studies to assess its long-term safety and effectiveness in cutaneous lupus.
The report was published by Jake Breimann from the Department of Dermatology, Temple University Lewis Katz School of Medicine, Philadelphia, USA, and colleagues.
Discoid lupus erythematosus is a chronic autoimmune skin disease characterized by inflammatory lesions that can cause scarring, skin atrophy, and pigmentary changes, particularly on sun-exposed areas. Standard treatments, including corticosteroids, antimalarials, and immunosuppressive therapies, are not always effective, leaving some patients with persistent disease and a significant cosmetic and psychological burden.
The case involved a 27-year-old woman who presented with a two-month history of painful, itchy, hyperpigmented, and erythematous plaques on her face, scalp, arms, and hands. Based on the clinical presentation and distribution of the lesions, she was diagnosed with DLE and referred for evaluation of systemic lupus erythematosus (SLE).
Laboratory testing revealed a positive antinuclear antibody (ANA) titer of 1:320, low C3 levels, and positive anti-RNP antibodies. She also reported knee synovitis and met established criteria for SLE based on cutaneous involvement, joint symptoms, positive ANA, and low complement levels.
Over the next two years, the patient underwent several treatment approaches. She received hydroxychloroquine, topical corticosteroids, and a prednisone taper, but these therapies failed to provide meaningful symptomatic or cosmetic improvement. Because of ongoing disease activity, she was subsequently treated with thalidomide for eight months. Although minor improvement was observed, treatment was complicated by peripheral sensory neuropathy.
Given the refractory nature of her disease and emerging evidence supporting interferon-targeted therapies, clinicians initiated treatment with anifrolumab, a monoclonal antibody that blocks type I interferon receptor signaling. The patient received monthly intravenous infusions of anifrolumab at a dose of 300 mg while continuing hydroxychloroquine and intermittent clobetasol therapy.
At the two-month follow-up, the patient reported substantial symptom improvement. Clinical examination showed only small residual hyperpigmented patches on the face, with no new lesions or disease flares.
According to the authors, this case adds to growing evidence that anifrolumab may be a useful option for patients with DLE that does not respond to conventional therapies. By targeting type I interferon signaling, a pathway believed to play a central role in lupus-related inflammation, the treatment may help control disease activity in difficult-to-manage cases.
The authors noted that, while the patient's response was encouraging, further studies are needed to establish the long-term efficacy, safety, and appropriate clinical use of anifrolumab in DLE. They emphasized that ongoing research into cytokine-targeted therapies could help improve outcomes for patients with this chronic and potentially disfiguring condition.
Reference:
Breimann J, Waseh S, Hsu S (May 03, 2026) Discoid Lupus Erythematosus Successfully Treated With Anifrolumab. Cureus 18(5): e108173. doi:10.7759/cureus.108173
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