{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T02:51:48Z","timestamp":1791082308887,"version":"4.1.0"},"reference-count":52,"publisher":"MDPI AG","issue":"16","license":[{"start":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T00:00:00Z","timestamp":1754870400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Objective: Anifrolumab is approved for systemic lupus erythematosus (SLE). Its off-label use in non-systemic cutaneous lupus erythematosus (NSCLE) remains poorly characterized. We aimed to assess its effectiveness and safety in refractory NSCLE, supported by a literature review and exploratory immunologic analysis. Methods: This multicenter observational study included patients with NSCLE treated with anifrolumab. Skin disease was assessed using the Cutaneous Lupus Erythematosus Disease Area and Severity Index (CLASI). CLASI scores at baseline were compared to months 1, 3, and 6. A narrative literature review was also conducted. In a subset of three patients, peripheral blood immunophenotyping was performed before and after treatment to explore immunologic surrogate markers associated with clinical response. Results: Fifteen patients (11 women; mean age 52.1 \u00b1 11.7 years) were included. All had received topical corticosteroids and hydroxychloroquine. Most of them had failed multiple systemic therapies. Anifrolumab (300 mg IV every 4 weeks) was used in combination (n = 12) or as monotherapy (n = 3). All patients improved. Median CLASI-A decreased from 16 to 1 (p &lt; 0.001); CLASI-D decreased from 5 to 4 (p &lt; 0.001). The literature review identified 6 publications reporting 14 additional cases of NSCLE with similar outcomes and minimal adverse effects. Immunologic profiling pointed to an increase in intermediate and non-classical and decreased PD-1 expression in monocytes and NK cells after 12 weeks of treatment. Conclusions: Anifrolumab appears effective and relatively safe in refractory NSCLE. Preliminary immunologic data suggest changes in peripheral blood monocyte subsets and NK cells. However, these findings must be confirmed in prospective, controlled clinical trials.<\/jats:p>","DOI":"10.3390\/jcm14165683","type":"journal-article","created":{"date-parts":[[2025,8,11]],"date-time":"2025-08-11T17:22:07Z","timestamp":1754932927000},"page":"5683","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Anifrolumab for Nonsystemic Cutaneous Lupus Erythematosus: Clinical Experience, Immunologic Insights, and Review of the Literature"],"prefix":"10.3390","volume":"14","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4754-0277","authenticated-orcid":false,"given":"Javier","family":"Loricera","sequence":"first","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"},{"name":"Immunopathology Group, IDIVAL, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carmen","family":"Bejerano","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"},{"name":"Immunopathology Group, IDIVAL, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5700-6281","authenticated-orcid":false,"given":"Andrea","family":"Est\u00e9banez","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital Universitario Doctor Peset, 46017 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irene","family":"Garc\u00eda","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital del Mar, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nasser","family":"Mohammad","sequence":"additional","affiliation":[{"name":"Department of Dermatology, Hospital del Mar, 08003 Barcelona, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mireia","family":"Sanmart\u00edn","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital General Universitario de Valencia, 46014 Valencia, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta","family":"Gonz\u00e1lez-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario de Basurto, 48013 Bilbao, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0197-5267","authenticated-orcid":false,"given":"Iv\u00e1n Ferraz","family":"Amaro","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Complejo Hospitalario Universitario de Canarias, 38320 Tenerife, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2423-5800","authenticated-orcid":false,"given":"Marcos A.","family":"Gonz\u00e1lez-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Immunopathology Group, IDIVAL, 39011 Santander, Spain"},{"name":"Department of Dermatology, Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0007-9590-5441","authenticated-orcid":false,"given":"Mayra V.","family":"Garc\u00eda-Contreras","sequence":"additional","affiliation":[{"name":"Immunopathology Group, IDIVAL, 39011 Santander, Spain"},{"name":"Department of Immunology, Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0562-427X","authenticated-orcid":false,"given":"Marcos","family":"L\u00f3pez-Hoyos","sequence":"additional","affiliation":[{"name":"Immunopathology Group, IDIVAL, 39011 Santander, Spain"},{"name":"Department of Immunology, Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"},{"name":"Molecular Biology Department, University of Cantabria, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Blanco","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Hospital Universitario Marqu\u00e9s de Valdecilla, 39008 Santander, Spain"},{"name":"Immunopathology Group, IDIVAL, 39011 Santander, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2025,8,11]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Fijalkowska, A., Kadziela, M., and Zebrowska, A. 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