Therapeutic Challenges in Polyautoimmunity: Anifrolumab for Lupus Erythematosus in Overlapping Autoimmune Syndromes

This case report discusses the use of anifrolumab, a monoclonal antibody targeting the interferon alpha receptor 1, in two patients with polyautoimmunity and refractory lupus erythematosus. The first patient, a 57-year-old woman with multiple sclerosis and amyopathic dermatomyositis, experienced significant improvement in periungual lesions after anifrolumab was added to her treatment, allowing for corticosteroid tapering. The second patient, a 60-year-old man with psoriasis vulgaris and systemic lupus erythematosus, showed rapid improvement in cutaneous lupus symptoms with anifrolumab, while his psoriasis remained stable. Anifrolumab's efficacy in these cases highlights its potential as an add-on therapy for refractory cutaneous symptoms in connective tissue diseases, despite being currently approved only for SLE. The report suggests that anifrolumab's targeted mechanism and safety profile make it a promising option for patients with overlapping autoimmune diseases.