CVD risk in lupus patients lower with anifrolumab vs belimumab

In the treatment of patients with systemic lupus erythematosus (SLE), anifrolumab is associated with reduced cardiovascular disease (CVD) risk compared with belimumab, as shown in a retrospective study.

Researchers used electronic health record data from 67 health care organizations in the TriNetX network. They looked at adults with SLE who initiated treatment with anifrolumab or belimumab and who had no history of CVD.

Study outcomes included 3-year risks of myocardial infarction, heart failure, ischaemic stroke, and major adverse cardiovascular events (MACEs).

A total of 1,091 patients who received anifrolumab (mean age 45.6 years) and 7,492 who received belimumab (mean age 43.7 years) met eligibility criteria. To balance demographics, comorbidities, laboratory data, and medication use between the anifrolumab and belimumab groups, the researchers performed propensity score matching, leaving 1,084 patients in each group.

In Cox regression analysis, treatment with anifrolumab reduced the risks of myocardial infarction by 37 percent (hazard ratio [HR], 0.63, 95 percent confidence interval [CI], 0.40–0.91), of heart failure by 45 percent (HR, 0.55, 95 percent CI, 0.39–0.75), of ischaemic stroke by 50 percent (HR, 0.50, 95 percent CI, 0.26–0.94), and of MACE by 35 percent (HR, 0.65, 95 percent CI, 0.37–0.89).

These findings support the consideration of anifrolumab as a therapeutic option in SLE, particularly in patients with increased CVD risk, according to the researchers. More prospective studies are needed to firmly establish causality, they added.