SLE — SCE Rheumatology MCQ

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HardSLE & Antiphospholipid SyndromeSLESCE Rheumatology

A 32-year-old woman with SLE and skin rash unresponsive to Hydroxychloroquine and Methotrexate is being considered for a biologic. She has moderate cutaneous lupus (rash >9% BSA) and arthritis. Which biologic has the strongest evidence for non-renal SLE manifestations according to EULAR 2023?

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Correct answer: A — Anifrolumab

EULAR 2023 recommends Anifrolumab (type I interferon receptor antagonist) and Belimumab for moderate-severe non-renal SLE unresponsive to standard therapy. Both have high-quality RCT evidence. Anifrolumab showed particular efficacy for skin manifestations in the TULIP trials. Prior use of a conventional immunosuppressive is not mandatory before initiating a biologic. Rituximab is reserved for refractory disease. Tocilizumab and Abatacept are not licensed for SLE.

Reference: EULAR 2023 - Recommendations for the management of systemic lupus erythematosus