Loncharich Michael F, Robertson Ian
Walter Reed National Military Medical Center, Bethesda, Maryland, USA.
Drugs Today (Barc). 2023 Feb;59(2):53-61. doi: 10.1358/dot.2023.59.2.3521876.
Systemic lupus erythematosus is a complex autoimmune disease with variable disease presentation and progression. Hydroxychloroquine and corticosteroids are first-line therapies. Disease severity and organ system involvement guide escalation of immunomodulatory medications beyond these mainstays. Anifrolumab is a first-in-class global type 1 interferon inhibitor recently approved by the United States Food and Drug Administration (FDA) for systemic lupus erythematosus in addition to standard of care. This article reviews the role of type 1 interferons in lupus pathophysiology and the evidence leading to anifrolumab's approval with particular emphasis on the MUSE, TULIP-1 and TULIP-2 trials. In addition to standard of care, anifrolumab can reduce corticosteroid requirements and reduce lupus disease activity, especially skin and musculoskeletal manifestations, with an acceptable safety profile.
系统性红斑狼疮是一种复杂的自身免疫性疾病，其疾病表现和进展具有多样性。羟氯喹和皮质类固醇是一线治疗药物。疾病严重程度和器官系统受累情况指导着在这些主要治疗方法之外增加免疫调节药物的使用。阿尼鲁单抗是全球首个获批的1型干扰素抑制剂，除标准治疗外，最近已被美国食品药品监督管理局（FDA）批准用于治疗系统性红斑狼疮。本文综述了1型干扰素在狼疮病理生理学中的作用以及阿尼鲁单抗获批的证据，特别强调了MUSE、TULIP - 1和TULIP - 2试验。除标准治疗外，阿尼鲁单抗可减少皮质类固醇的用量，并降低狼疮疾病活动度，尤其是皮肤和肌肉骨骼表现，且安全性可接受。
