{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T12:08:11Z","timestamp":1790078891110,"version":"4.0.1"},"reference-count":35,"publisher":"MDPI AG","issue":"18","license":[{"start":{"date-parts":[[2026,9,17]],"date-time":"2026-09-17T00:00:00Z","timestamp":1789603200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Clin. Med.","JCM"],"abstract":"<jats:p>Background and Objectives: Real-world data on anifrolumab in Egyptian patients with moderate-to-severe systemic lupus erythematosus (SLE) remain limited. This study aimed to evaluate the real-world effectiveness and safety of anifrolumab in Egyptian patients with moderate-to-severe SLE. Materials and Methods: This retrospective, multicenter, observational cohort study reviewed the medical records of 80 adults with moderate-to-severe SLE who had received at least 6 doses (\u226520 weeks) of intravenous anifrolumab 300 mg every 4 weeks as part of routine clinical care at 13 Egyptian tertiary rheumatology centers; medical record review and data extraction were performed between May and July 2026. Outcomes were assessed at baseline and final follow-up and included disease activity, lupus low disease activity state (LLDAS), glucocorticoid use, flare status, laboratory parameters, and adverse events. Results: Patients were predominantly female (98.8%), with a mean age of 30.4 \u00b1 9.8 years. Disease activity improved, with SLEDAI-2K decreasing from 11 to 4 (p &lt; 0.001), PGA from 2.7 to 0.5 (p &lt; 0.001), LLDAS increasing from 0% to 51.3% (p &lt; 0.001), and flares decreasing from 95.0% to 18.8% (p &lt; 0.001). Glucocorticoid burden also declined, with oral glucocorticoid use falling from 95.0% to 83.8% (p = 0.021), median prednisone dose from 20 mg\/day to 5 mg\/day (p &lt; 0.001), intravenous methylprednisolone use from 50.0% to 6.3% (p &lt; 0.001), and 63.8% achieving prednisone doses \u2264 7.5 mg\/day (p &lt; 0.001). Laboratory improvement included hemoglobin, leukocyte count, lymphocyte count, platelet count, C3, C4, anti-dsDNA, C-reactive protein (CRP), and erythrocyte sedimentation rate (ESR), while serum creatinine did not change significantly (p = 0.904). No serious adverse events were reported. Conclusions: Anifrolumab was associated with significant short-term improvement in clinical and laboratory disease activity, marked steroid sparing, and reduced flare burden in Egyptian patients with moderate-to-severe SLE, with acceptable short-term tolerability.<\/jats:p>","DOI":"10.3390\/jcm15187241","type":"journal-article","created":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T11:09:35Z","timestamp":1790075375000},"page":"7241","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study"],"prefix":"10.3390","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9892-2449","authenticated-orcid":false,"given":"Samar","family":"Tharwat","sequence":"first","affiliation":[{"name":"Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt"},{"name":"Department of Internal Medicine, Faculty of Medicine, Horus University, New Damietta 34518, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"formal-analysis","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"},{"role":"writing-original-draft","vocabulary":"credit"},{"role":"supervision","vocabulary":"credit"}]},{"given":"Samah A.","family":"El Bakry","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Shereen Abdelsalam","family":"Olwan","sequence":"additional","affiliation":[{"name":"Rheumatology, Rehabilitation and Physical Medicine Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Fatma","family":"Fayed","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Unit, Internal Medicine Department, Students\u2019 Hospital, Alexandria University, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"conceptualization","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Enas S.","family":"Zahran","sequence":"additional","affiliation":[{"name":"Rheumatology and Immunology Unit, Internal Medicine Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom 32511, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Maie","family":"Helal","sequence":"additional","affiliation":[{"name":"Rheumatology, Rehabilitation and Physical Medicine Department, Faculty of Medicine, Alexandria University, Alexandria 21521, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Mai M.","family":"Morsy","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Abeer Abdelmonem","family":"Shahba","sequence":"additional","affiliation":[{"name":"Rheumatology & Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta 31527, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Rehab","family":"Elnemr","sequence":"additional","affiliation":[{"name":"Rheumatology, Rehabilitation and Physical Medicine Department, Faculty of Medicine, Alexandria University, Alexandria 21521, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Nehad Mohamed","family":"Elshatby","sequence":"additional","affiliation":[{"name":"Rheumatology, Rehabilitation and Physical Medicine Department, Faculty of Medicine, Alexandria University, Alexandria 21521, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8065-0502","authenticated-orcid":false,"given":"Nevine","family":"Mohannad","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University Hospitals, Alexandria University, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6013-2038","authenticated-orcid":false,"given":"Gehad","family":"Maghraby","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Kamel Heshmat","family":"Gado","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Manal","family":"Tayel","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-3690-0572","authenticated-orcid":false,"given":"Yasmine","family":"Abu Halawa","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Dina","family":"Shahin","sequence":"additional","affiliation":[{"name":"Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Ahmed Yehia","family":"Ismaeel","sequence":"additional","affiliation":[{"name":"Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9040-7626","authenticated-orcid":false,"given":"Eiman","family":"Soliman","sequence":"additional","affiliation":[{"name":"Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"},{"role":"methodology","vocabulary":"credit"},{"role":"writing-review-editing","vocabulary":"credit"}]},{"given":"Eman F.","family":"Mohamed","sequence":"additional","affiliation":[{"name":"Rheumatology Unit, Internal Medicine Department, Faculty of Medicine (Girls), Al-Azhar University, Cairo 11651, Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2026,9,17]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1219","DOI":"10.1111\/imj.15448","article-title":"Systemic Lupus Erythematosus: A Clinical Update","volume":"51","author":"Connelly","year":"2021","journal-title":"Intern. Med. J."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"999","DOI":"10.1136\/ard-2022-223741","article-title":"Pathogenesis of Systemic Lupus Erythematosus: Risks, Mechanisms and Therapeutic Targets","volume":"82","author":"Crow","year":"2023","journal-title":"Ann. Rheum. Dis."},{"key":"ref_3","doi-asserted-by":"crossref","first-page":"87","DOI":"10.1016\/j.coi.2020.10.014","article-title":"Type I Interferon in the Pathogenesis of Systemic Lupus Erythematosus","volume":"67","author":"Postal","year":"2020","journal-title":"Curr. Opin. Immunol."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"1104","DOI":"10.1093\/rheumatology\/kead348","article-title":"Glucocorticoid Treatment in SLE Is Associated with Infections, Comorbidities and Mortality-a National Cohort Study","volume":"63","author":"Frodlund","year":"2024","journal-title":"Rheumatology"},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"e001114","DOI":"10.1136\/lupus-2023-001114","article-title":"Clinical Trial Outcomes for SLE: What We Have and What We Need","volume":"11","author":"Arnaud","year":"2024","journal-title":"Lupus Sci. Med."},{"key":"ref_6","doi-asserted-by":"crossref","first-page":"115738","DOI":"10.1016\/j.isci.2026.115738","article-title":"From Pathogenesis to Precision Medicine in Systemic Lupus Erythematosus: Emerging Biomarkers and Targeted Interventions","volume":"29","author":"Lan","year":"2026","journal-title":"iScience"},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"253","DOI":"10.1002\/art.42392","article-title":"A Randomized, Placebo-Controlled Phase III Extension Trial of the Long-Term Safety and Tolerability of Anifrolumab in Active Systemic Lupus Erythematosus","volume":"75","author":"Kalunian","year":"2023","journal-title":"Arthritis Rheumatol."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"e000284","DOI":"10.1136\/lupus-2018-000284","article-title":"Anifrolumab Effects on Rash and Arthritis: Impact of the Type I Interferon Gene Signature in the Phase IIb MUSE Study in Patients with Systemic Lupus Erythematosus","volume":"5","author":"Merrill","year":"2018","journal-title":"Lupus Sci. 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