#2-87E. Breaking New Ground: Anifrolumab Continuation Throughout Pregnancy in SLE (Ann Rheum Dis, 2025)

Managing systemic lupus erythematosus (SLE) during pregnancy presents a complex challenge, particularly when balancing disease control with fetal safety against novel therapeutics. Today we discuss a pioneering case report detailing a 36-year-old patient with SLE who continued anifrolumab, a type I interferon receptor antibody, throughout her entire pregnancy. Despite the lack of prior safety data, the patient maintained low disease activity and successfully delivered a healthy full-term infant via caesarean section without neonatal lupus or congenital anomalies. The core significance of this study lies in being the first documented report of successful childbirth following continuous anifrolumab exposure from conception to delivery, suggesting it may be a potential strategy to minimize glucocorticoid toxicity in high-risk pregnancies. However, physicians must exercise critical caution as this is a single case report, and safety profiles regarding teratogenicity and long-term fetal outcomes remain unestablished in larger cohorts. For clinicians, this case offers critical preliminary evidence to support shared decision-making when standard pregnancy-compatible immunosuppressants are insufficient or when steroid-sparing strategies are prioritized to improve maternal and fetal outcomes.

Citation: Kitada A, Tsuboi H, Ebe H, et al. A case of systemic lupus erythematosus with favourable pregnancy outcome following continued administration of anifrolumab during pregnancy. Ann Rheum Dis. 84(12), 2141-2143, 2025. DOI: 10.1016/j.ard.2025.06.2135

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