TOPLINE

Anifrolumab was associated with rapid cutaneous improvement in patients with refractory dermatomyositis (DM), with skin disease activity scores decreasing by more than half within 1 month of treatment initiation and more than 90% of those on corticosteroids at baseline achieving a dose reduction by month 6.

METHODOLOGY

• Researchers conducted a multicentre retrospective study across seven dermatology, six internal medicine, and rheumatology departments in France between January 2024 and 2026.
• They included 26 adults (median age at diagnosis, 54 years; 81% women) with refractory DM (European Neuromuscular Centre 2018 criteria) and cutaneous involvement who received at least one dose of anifrolumab (300 mg intravenously monthly).
• Patients were heavily pretreated, with a median of five prior treatment lines (range, 2-9), including oral corticosteroids (96%), methotrexate (100%), intravenous immunoglobulins (92%), and JAK inhibitors (62%).
• The primary outcome was an improvement in the Cutaneous Dermatomyositis Disease Area and Severity Index-Activity (CDASI-A) score, and secondary outcomes were an improvement in Manual Muscle Testing 8 (MMT-8) scores, corticosteroid tapering, and safety assessment.

TAKEAWAY

• CDASI-A scores decreased from a median of 14 (IQR, 10-18) at baseline to 6 (IQR, 4-10) at month 1, with sustained improvement observed at month 3 (median, 6 [IQR, 2-8]), month 6 (median, 2 [IQR, 0-4]), and month 12 (median, 4 [IQR, 2-7]) compared with baseline (P < .01 for all).
• MMT-8 scores improved from a median of 144 (IQR, 128-150) at baseline, with statistically significant improvements observed at both months 3 and 6 (P < .01 for both).
• Among 14 patients who received corticosteroids at baseline, 12 of 13 assessed at month 6 (92%) experienced a dose reduction, of whom nine (69%) reached ≤ 5 mg/d and three had stopped corticosteroids completely.
• Adverse events occurred in 8 of the 26 patients (31%), predominantly infections in five patients (19%), including one herpes zoster reactivation and one arthralgia, and one patient died from respiratory failure of undetermined cause.

IN PRACTICE

"We report rapid and significant cutaneous and muscle improvement in refractory DM with anifrolumab," the authors wrote. "Together with the efficacy of anti–IFN-β [interferon-beta] therapy, these findings support the central role of the IFN-I [type 1 IFN] pathway and the potential of targeted therapies in DM. The near-maximal baseline MMT-8 reflects the pauci-myopathic character of this cohort, whose muscle disease had largely been controlled by prior treatment lines, highlighting refractory cutaneous involvement as the main unmet need and the potential role of anifrolumab in this setting," they added.

SOURCE

The study was led by Chloé Grolleau, AP-HP, Hôpital Saint-Louis, Service de Dermatologie, Paris, France. It was published online on July 14, 2026, in the Journal of the European Academy of Dermatology & Venereology.

LIMITATIONS

This study was limited by the retrospective design, missing data at month 12, and the presence of concomitant therapies, all of which may have influenced outcomes.

DISCLOSURES

The authors did not report any funding information. Several authors reported receiving research funding, consulting fees, speaker honoraria, or travel support and serving in advisory roles for multiple pharmaceutical companies. Full disclosures are noted in the original article.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.