Lupus & antiphospholipid syndrome

Anifrolumab Versus Belimumab for Cardiovascular Disease Risk in Systemic Lupus Erythematosus

Arthritis RheumatolPublished Target trial emulation

Main finding · MIResult — go to the resultHazard ratio 0.63 95% CI 0.40–0.91

Authors' conclusion

Anifrolumab treatment was associated with lower CVD risk compared with belimumab in patients with SLE

Study context

Population
Adults with systemic lupus erythematosus (SLE) initiating anifrolumab or belimumab without prior cardiovascular disease (CVD), TriNetX network, 2020–20251,084 matched pairs
Participants
1,091 vs 7,492
Exposure
Anifrolumab vs belimumab
  • Anifrolumabn = 1,091
  • Belimumabn = 7,492reference
Outcome
Risks of myocardial infarction (MI), heart failure (HF), ischemic stroke and MACE
Follow-up
Three years
Methodological detailsretrospective cohort study, propensity-score matched, electronic health record data, 67 health care organizations, TriNetX network, Cox regression
  • Retrospective cohort study
  • Propensity-score matched
  • Electronic health record data
  • 67 health care organizations, TriNetX network
  • Cox regression

Main finding

MI

Hazard ratio

0.63

95% CI 0.40–0.91

Anifrolumabvs Belimumab
HR 0.63 (95% CI 0.40–0.91)

As reported in the abstract

Observational data: associations, not effects.

Further findings

OutcomeHR (95% CI)
HF · three years0.55 (0.39–0.75)
Ischemic stroke · three years0.50 (0.26–0.94)
MACE · three years0.65 (0.37–0.89)

Original publication

Anifrolumab Versus Belimumab for Cardiovascular Disease Risk in Systemic Lupus Erythematosus. Arthritis Rheumatol. Published 7 August 2026. doi:10.1002/art.70293

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