Efficacy of Anifrolumab in the treatment of mucocutaneous manifestations of lupus erythematosus: a scoping review

Aim of the work Cutaneous lupus erythematosus (CLE) is a heterogeneous, often treatment-refractory entity. Anifrolumab has shown efficacy in systemic lupus erythematosus (SLE), but efficacy in CLE is less clearly defined. We aim to map evidence on its efficacy and safety across CLE subtypes and lupus-related mucocutaneous manifestations. Patients and Methods Systematic search of PubMed, Scopus, Web of Science, and Cochrane Library (inception to October 10, 2025). We included anifrolumab studies on CLE, along with SLE studies that reported extractable mucocutaneous outcomes. Adverse events and treatment discontinuations were extracted where available. Results Fifty studies (29 case series, 21 case reports) included 205 patients (88% female; 12–78 years). Discoid LE (DLE) was most frequently reported (32 studies), with complete and partial responses in a significant proportion of patients (47/84 and 36/84, respectively). Lupus panniculitis showed favorable responses among evaluated patients (5/7 complete; 2/7 partial). Tumid lupus achieved complete response in all cases ( n = 6), and chilblain lupus improved in most (8/11 complete; 3/11 partial). In subacute CLE (SCLE) and acute CLE (ACLE), complete responses (SCLE 33/52; ACLE 16/31) outnumbered partial ones (SCLE 17/52; ACLE 12/31), with relapses mainly linked to treatment interruption or systemic flares. Alopecia and mucosal lesions also improved (complete response in 16/34 and 18/26 of cases, respectively). Adverse events were mostly mild; serious events were uncommon. Conclusions Available evidence, largely from small observational studies, suggests potential efficacy of anifrolumab across CLE subtypes and lupus-related mucocutaneous manifestations, with a safety profile consistent with that reported in major SLE trials.