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Complement and autoantibody levels under anifrolumab therapy in SLE: implications for clinical practice
Jan-Gerd Rademacher1, Björn Tampe1, Peter Korsten1,2
1Department of Nephrology and Rheumatology, University Medical Center Göttingen, Göttingen, Germany.
Frontiers in Immunology
|March 27, 2026
Summary
Anifrolumab improved systemic lupus erythematosus (SLE) clinical symptoms but did not alter key serological markers like complement or anti-dsDNA antibodies. Focus on clinical assessment for monitoring Anifrolumab treatment effectiveness in SLE patients.
Area of Science:
- Rheumatology
- Immunology
- Pharmacology
Background:
- Anifrolumab (ANI) is a type I interferon receptor antagonist effective for systemic lupus erythematosus (SLE).
- The impact of ANI on common serological markers of SLE disease activity is not well-established.
- This study investigates ANI's effect on complement and autoantibody levels in routine SLE care.
Purpose of the Study:
- To evaluate changes in complement (C3c, C4) and anti-double-stranded DNA (anti-dsDNA) antibody levels in SLE patients treated with Anifrolumab.
- To assess the correlation between clinical improvement and serological marker changes during Anifrolumab therapy.
- To determine the utility of traditional serological markers in monitoring Anifrolumab treatment response in SLE.
Main Methods:
- Retrospective analysis of 13 SLE patients receiving at least 3 Anifrolumab infusions over 12 months.
- Mixed-effects modeling (REML) analyzed changes in SLE Disease Activity Index 2000 (SLEDAI-2K), complement levels, anti-dsDNA antibodies, and prednisone dosage.
- Correlations between clinical SLEDAI-2K changes (excluding serological components) and serological markers were examined.
Main Results:
- Significant clinical improvement observed, with mean SLEDAI-2K reduction of 3.77 points (p < 0.001) in 76.9% of patients.
- Complement (C3c, C4) and anti-dsDNA antibody levels remained largely unchanged throughout the treatment period (p > 0.10 for all).
- No significant correlation was found between clinical improvement and changes in serological markers.
Conclusions:
- Anifrolumab treatment leads to significant clinical benefits in SLE patients.
- Traditional serological markers (complement, anti-dsDNA) may not accurately reflect Anifrolumab's therapeutic response.
- Clinical assessment is crucial for monitoring Anifrolumab efficacy, potentially requiring re-evaluation of composite indices that include serological components.
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