Marked improvement of oral manifestations in systemic lupus erythematosus after therapy with IFNAR1 blocking antibody (anifrolumab): A case report.

BACKGROUND

Secondary Sjögren's syndrome (sSD) is a typical oral manifestation of systemic lupus erythematosus (SLE), which manifests itself in the form of xerostomia and mucositis and often makes dental treatment more complex. Anifrolumab, a type I interferon receptor antagonist (IFNAR1), was recently approved for the treatment of moderate-to-severe SLE. However, its potential benefit in sSD-particularly in addressing oral disease burden-remains unreported.

CASE PRESENTATION: We describe a 40-year-old woman diagnosed with SLE, secondary Sjögren's syndrome, rheumatoid arthritis, and osteopenia, who presented with persistent xerostomia, mucosal inflammation, joint pain, and cutaneous lupus despite long-term immunosuppressive therapy. Anifrolumab (300 mg IV every 28 days) was initiated in November 2022. Over the subsequent six months, the patient experienced marked improvement in cutaneous and systemic symptoms, alongside enhanced salivary flow and reduced oral inflammation. The resolution of xerostomia facilitated successful dental rehabilitation, including sinus floor augmentation, socket preservation and dental implant-supported prosthetics.

DISCUSSION: This case illustrates the broader therapeutic potential of interferon blockade in autoimmune diseases with mucosal involvement. By targeting IFNAR1, anifrolumab may interrupt the pathogenic loop of type I interferon-driven inflammation and B-cell dysregulation, resulting in both systemic and oral clinical improvement.

CONCLUSION

Anifrolumab may offer meaningful benefit for patients with secondary Sjögren's syndrome beyond conventional SLE control, particularly in improving oral health outcomes. Further clinical studies are warranted to evaluate its efficacy in mucosal autoimmune manifestations.