Table 1 Open in new tab Antibodies...

Antibody

Anifrolumab

Belimumab

Target

IFNI receptor

BAFF

Efficiency

1. The DAI-based belimumab is two times more effective, which can, in particular, be explained by inhibition of the IFNI signaling cascade, which leads to an initial blocking of many pathological pathways, including both cellular and humoral autoimmune responses.
2. Taking anifrolumab can completely eliminate the need for corticosteroids.

1. The lower efficacy compared to anifrolumab is due, in part, to its targeting of BAFF, which blocks the maturation of autoimmune B cells without affecting other autoimmune processes.
2. Taking belimumab can reduce the use of corticosteroids.

Safety

Mild to moderate AEs. The most common AEs are associated with upper respiratory tract infections (up to 20%), as well as an increased incidence of opportunistic infections, which may be due to greater suppression of the immune system due to blocking IFNI signaling.

Mild to moderate AEs. The most common AEs are associated with upper respiratory tract infections (up to 20%); no opportunistic infections were observed. It showed a slightly better safety profile compared to anifrolumab, which may be due to less immunosuppression.

Future prospects

It is advisable to conduct clinical trials in pediatric patients since the presence of the only approved monoclonal antibody for the treatment of SLE (belimumab) makes this group of patients still highly vulnerable.

It is promising to think about modifications to the belimumab molecule that will reduce the immunogenicity and increase the safety of this antibody. This will make it more likely to prescribe belimumab to patients who have contraindications for taking this group of drugs.

Table 1

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Antibodies approved for the treatment of SLE: comparison and analysis

Antibody	Anifrolumab	Belimumab
Target	IFNI receptor	BAFF
Efficiency	1. The DAI-based belimumab is two times more effective, which can, in particular, be explained by inhibition of the IFNI signaling cascade, which leads to an initial blocking of many pathological pathways, including both cellular and humoral autoimmune responses. 2. Taking anifrolumab can completely eliminate the need for corticosteroids.	1. The lower efficacy compared to anifrolumab is due, in part, to its targeting of BAFF, which blocks the maturation of autoimmune B cells without affecting other autoimmune processes. 2. Taking belimumab can reduce the use of corticosteroids.
Safety	Mild to moderate AEs. The most common AEs are associated with upper respiratory tract infections (up to 20%), as well as an increased incidence of opportunistic infections, which may be due to greater suppression of the immune system due to blocking IFNI signaling.	Mild to moderate AEs. The most common AEs are associated with upper respiratory tract infections (up to 20%); no opportunistic infections were observed. It showed a slightly better safety profile compared to anifrolumab, which may be due to less immunosuppression.
Future prospects	It is advisable to conduct clinical trials in pediatric patients since the presence of the only approved monoclonal antibody for the treatment of SLE (belimumab) makes this group of patients still highly vulnerable.	It is promising to think about modifications to the belimumab molecule that will reduce the immunogenicity and increase the safety of this antibody. This will make it more likely to prescribe belimumab to patients who have contraindications for taking this group of drugs.

Antibody	Anifrolumab	Belimumab
Target	IFNI receptor	BAFF
Efficiency	1. The DAI-based belimumab is two times more effective, which can, in particular, be explained by inhibition of the IFNI signaling cascade, which leads to an initial blocking of many pathological pathways, including both cellular and humoral autoimmune responses. 2. Taking anifrolumab can completely eliminate the need for corticosteroids.	1. The lower efficacy compared to anifrolumab is due, in part, to its targeting of BAFF, which blocks the maturation of autoimmune B cells without affecting other autoimmune processes. 2. Taking belimumab can reduce the use of corticosteroids.
Safety	Mild to moderate AEs. The most common AEs are associated with upper respiratory tract infections (up to 20%), as well as an increased incidence of opportunistic infections, which may be due to greater suppression of the immune system due to blocking IFNI signaling.	Mild to moderate AEs. The most common AEs are associated with upper respiratory tract infections (up to 20%); no opportunistic infections were observed. It showed a slightly better safety profile compared to anifrolumab, which may be due to less immunosuppression.
Future prospects	It is advisable to conduct clinical trials in pediatric patients since the presence of the only approved monoclonal antibody for the treatment of SLE (belimumab) makes this group of patients still highly vulnerable.	It is promising to think about modifications to the belimumab molecule that will reduce the immunogenicity and increase the safety of this antibody. This will make it more likely to prescribe belimumab to patients who have contraindications for taking this group of drugs.

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