Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study

Tharwat, Samar; El Bakry, Samah A.; Olwan, Shereen Abdelsalam; Fayed, Fatma; Zahran, Enas S.; Helal, Maie; Morsy, Mai M.; Shahba, Abeer Abdelmonem; Elnemr, Rehab; Elshatby, Nehad Mohamed; Mohannad, Nevine; Maghraby, Gehad; Gado, Kamel Heshmat; Tayel, Manal; Abu Halawa, Yasmine; Shahin, Dina; Ismaeel, Ahmed Yehia; Soliman, Eiman; Mohamed, Eman F.

doi:10.3390/jcm15187241

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Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study

by

Samar Tharwat

^1,2,*

,

Samah A. El Bakry

³,

Shereen Abdelsalam Olwan

⁴,

Fatma Fayed

⁵,

Enas S. Zahran

⁶,

Maie Helal

⁷,

Mai M. Morsy

⁸,

Abeer Abdelmonem Shahba

⁹,

Rehab Elnemr

⁷,

Nehad Mohamed Elshatby

⁷,

Nevine Mohannad

¹⁰

,

Gehad Maghraby

¹¹

,

Kamel Heshmat Gado

¹¹,

Manal Tayel

⁸,

Yasmine Abu Halawa

⁸,

Dina Shahin

¹,

Ahmed Yehia Ismaeel

¹²,

Eiman Soliman

⁸

and

Eman F. Mohamed

¹³

¹

Rheumatology & Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Mansoura University, Mansoura 35516, Egypt

²

Department of Internal Medicine, Faculty of Medicine, Horus University, New Damietta 34518, Egypt

³

Rheumatology Unit, Department of Internal Medicine, Faculty of Medicine, Ain Shams University, Cairo 11566, Egypt

⁴

Rheumatology, Rehabilitation and Physical Medicine Department, Faculty of Medicine, Tanta University, Tanta 31527, Egypt

⁵

Rheumatology and Immunology Unit, Internal Medicine Department, Students’ Hospital, Alexandria University, Alexandria 21526, Egypt

⁶

Rheumatology and Immunology Unit, Internal Medicine Department, Faculty of Medicine, Menoufia University, Shebeen El-Kom 32511, Egypt

⁷

Rheumatology, Rehabilitation and Physical Medicine Department, Faculty of Medicine, Alexandria University, Alexandria 21521, Egypt

⁸

Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University, Alexandria 21526, Egypt

⁹

Rheumatology & Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Tanta University, Tanta 31527, Egypt

¹⁰

Rheumatology and Clinical Immunology Unit, Department of Internal Medicine, Faculty of Medicine, Alexandria University Hospitals, Alexandria University, Alexandria 21526, Egypt

¹¹

Rheumatology and Clinical Immunology Unit, Internal Medicine Department, Faculty of Medicine, Cairo University, Cairo 11562, Egypt

¹²

Internal Medicine Department, Faculty of Medicine, Beni-Suef University, Beni-Suef 62511, Egypt

¹³

Rheumatology Unit, Internal Medicine Department, Faculty of Medicine (Girls), Al-Azhar University, Cairo 11651, Egypt

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Author to whom correspondence should be addressed.

J. Clin. Med. 2026, 15(18), 7241; https://doi.org/10.3390/jcm15187241 (registering DOI)

Submission received: 21 July 2026 / Revised: 12 September 2026 / Accepted: 16 September 2026 / Published: 17 September 2026

(This article belongs to the Special Issue New Advances in Systemic Lupus Erythematosus (SLE))

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Abstract

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 (≥20 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 ± 9.8 years. Disease activity improved, with SLEDAI-2K decreasing from 11 to 4 (p < 0.001), PGA from 2.7 to 0.5 (p < 0.001), LLDAS increasing from 0% to 51.3% (p < 0.001), and flares decreasing from 95.0% to 18.8% (p < 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 < 0.001), intravenous methylprednisolone use from 50.0% to 6.3% (p < 0.001), and 63.8% achieving prednisone doses ≤ 7.5 mg/day (p < 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.

Keywords: systemic lupus erythematosus; anifrolumab; Egyptian patients; type I interferon inhibitor

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MDPI and ACS Style

Tharwat, S.; El Bakry, S.A.; Olwan, S.A.; Fayed, F.; Zahran, E.S.; Helal, M.; Morsy, M.M.; Shahba, A.A.; Elnemr, R.; Elshatby, N.M.; et al. Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study. J. Clin. Med. 2026, 15, 7241. https://doi.org/10.3390/jcm15187241

AMA Style

Tharwat S, El Bakry SA, Olwan SA, Fayed F, Zahran ES, Helal M, Morsy MM, Shahba AA, Elnemr R, Elshatby NM, et al. Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study. Journal of Clinical Medicine. 2026; 15(18):7241. https://doi.org/10.3390/jcm15187241

Chicago/Turabian Style

Tharwat, Samar, Samah A. El Bakry, Shereen Abdelsalam Olwan, Fatma Fayed, Enas S. Zahran, Maie Helal, Mai M. Morsy, Abeer Abdelmonem Shahba, Rehab Elnemr, Nehad Mohamed Elshatby, and et al. 2026. "Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study" Journal of Clinical Medicine 15, no. 18: 7241. https://doi.org/10.3390/jcm15187241

APA Style

Tharwat, S., El Bakry, S. A., Olwan, S. A., Fayed, F., Zahran, E. S., Helal, M., Morsy, M. M., Shahba, A. A., Elnemr, R., Elshatby, N. M., Mohannad, N., Maghraby, G., Gado, K. H., Tayel, M., Abu Halawa, Y., Shahin, D., Ismaeel, A. Y., Soliman, E., & Mohamed, E. F. (2026). Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study. Journal of Clinical Medicine, 15(18), 7241. https://doi.org/10.3390/jcm15187241

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Real-World Effectiveness and Safety of Anifrolumab in Egyptian Patients with Moderate-to-Severe Systemic Lupus Erythematosus: A Retrospective Multicenter Study

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