Anifrolumab

What is anifrolumab?  

Anifrolumab is a type of medicine called a biological disease-modifying antirheumatic drug (bDMARD). It is used to treat systemic lupus erythematosus (SLE). 

Type 1 interferons (INF) are proteins that help your body fight viruses. In SLE, the body produces too much INF, which can cause problems with your skin, joints, and other organs. 

By impacting on the way these INF proteins work, anifrolumab reduces inflammation and lessens the symptoms associated with SLE.   

What benefit can you expect from your treatment? 

You may notice improvements in skin rashes and joint pain, stiffness, and swelling within the first 12 weeks of starting. Your doctor may be able to gradually reduce the dose of steroids if you are currently taking this medicine. 

Stopping anifrolumab 

Keep taking your treatment unless your doctor tells you to stop or if you experience any side effects (see Side effects). If you stop anifrolumab for any reason you must contact your doctor. 

How will your condition be monitored?  

Regular check-ups with your rheumatologist and blood tests will be required to monitor your condition and how well the treatment is working.   

If you have an active infection, see your doctor to have this treated as soon as possible.  

How is anifrolumab given?  

Anifrolumab is given through a ‘drip’ (intravenous infusion) every 4 weeks, but it is possible your rheumatologist may change this over time. 

Can other medicines be taken with anifrolumab?  

Anifrolumab can be taken with other lupus medicines. Anifrolumab is not used with other bDMARDs. 

How long is the treatment continued?  

In clinical trials, anifrolumab has been studied for several years. Currently, there is no known time limit for how long it can be used if it continues to treat lupus effectively and does not cause harmful side effects. 

Are there any side effects? 

You might experience side effects with your treatment. Contact your doctor if you have any concerns about possible side effects. Many side effects will go away when anifrolumab is stopped.  

Most common possible side effects:  

The most common side effects with anifrolumab include: 

• Upper respiratory tract infections such as sore throat, runny nose
• A mild reaction during the infusion
• Bronchitis (chest infection)
• Shingles, which is a type of painful rash that can happen to anyone who has previously had chicken pox. It is more common in people on anifrolumab.  Discuss with your doctor about having the Shingrix vaccine which can help protect you from shingles. If you have symptoms of shingles, contact your doctor as this can be treated with medicine which can make the infection less severe.

Less common or rare possible side effects:  

The serious side effects with anifrolumab include: 

• Pneumonia and other serious infections which can require going to hospital.
• Worsening of SLE characterised by flares
• Serious hypersensitivity reactions including anaphylaxis (less than 1%).

What precautions are necessary? 

Infections 

Anifrolumab will not be given if you have an active infection. It is usual to be screened for chronic infections before giving anifrolumab, which may include:  

• Blood tests for previous hepatitis B and C, chicken pox, HIV and tuberculosis
• Chest X-ray.

Vaccines 

• If you are on anifrolumab it is recommended you should not have ‘live’ vaccines such as MMR (measles, mumps and rubella), OPV (for polio given by mouth), BCG (the vaccine for TB) or yellow fever vaccine. Talk with your rheumatologist before receiving any vaccines.
• Shingrix is a safe and effective vaccine in protecting you from shingles. You should not receive the old Zostavax for shingles, which is also a live vaccine.  
• Pneumococcal, yearly flu and COVID vaccinations are safe and encouraged whilst on anifrolumab.
• More detailed information on vaccination is available on the ARA website: https://rheumatology.org.au/For-Patients/Medication-Information/Vaccinations-in-Rheumatology

Cancer risk 

• It is not yet known if anifrolumab increases the risk of cancer.
• To help prevent cancer, it is important to stop smoking and take steps to protect your skin from the sun. Regular skin checks are also recommended.

Use with other medicines 

• Anifrolumab may interact with some medicines. 
• You should tell your doctor (including your GP, rheumatologist, and other health professionals) about all medicines you are taking, including herbal, natural and over-the-counter medicines.

Use with alcohol 

• You may drink alcohol in moderation while on anifrolumab. However, alcohol may be a problem with some other medicines, for example, methotrexate. 

Use in pregnancy and when breastfeeding  

• Not much is known about the possible effects of anifrolumab on the unborn baby. If you plan to become pregnant, you should discuss this with your rheumatologist. 
• Anifrolumab use during breastfeeding has not been studied, however it is likely that little, if any, passes on to the unborn baby. Please speak to your rheumatologist for more information.

IMPORTANT THINGS TO REMEMBER 

• While taking anifrolumab you must see your rheumatologist regularly to ensure the treatment is working and check for any possible side effects. 
• You should have regular blood tests as suggested by your rheumatologist. 
• If you are worried about any side effects, you should contact your rheumatologist as soon as possible. 
• It is important to tell your doctor if you develop any infections including shingles while taking anifrolumab.
• If you are taking anifrolumab and plan to become pregnant you must discuss the timing with your doctor.

For more information see the Anifrolumab – printable information sheet

This Information Sheet has been prepared using materials obtained from various sources which have been reviewed by the Australian Rheumatology Association (ARA). It contains general information only and does not contain a complete or definitive statement of all possible uses, actions, precautions, side effects or interactions of the medicines referenced. This information is not intended as medical advice for individual conditions nor for making an individual assessment of the risks and benefits of taking a particular medicine. Decisions regarding the assessment and treatment of patients are the sole responsibility of the treating medical professional, exercising their own clinical judgment and taking into account all of the circumstances and the medical history of the individual patient.
ARA has used all reasonable endeavours to ensure the information on which this Information Sheet is based is accurate and up to date. However, the ARA accepts no responsibility or liability for the accuracy, currency, reliability and/or completeness of the information contained in this Information Sheet.  To the maximum extent permitted by law, the ARA expressly disclaims any liability for any injury, loss, harm or damage arising from or in connection with use of and reliance on the information contained in this Information Sheet.