For individuals with systemic lupus erythematosus (SLE), fatigue is a persistent and often debilitating symptom of the disease itself. When starting a new biologic treatment like Saphnelo (anifrolumab), it is reasonable to question how a new medication might impact energy levels. The short answer is yes, a Saphnelo infusion can make you tired, though this is typically a temporary side effect of an infusion-related reaction.
Understanding Saphnelo and Infusion Reactions
Saphnelo is an intravenous (IV) infusion therapy prescribed for adults with moderate to severe SLE. It works by targeting and blocking the Type 1 interferon (IFN) pathway, a critical component of the immune system that is overactive in many lupus patients. While this action helps reduce overall disease activity, it can also trigger what is known as an infusion-related reaction.
An infusion reaction is the body's response to the administered medication and can occur during or shortly after the treatment. These reactions are not uncommon with biologics, and in clinical trials for Saphnelo, the incidence was reported to be just under 10%. Your healthcare team will monitor you closely during and after the 30-minute infusion to manage any reactions that arise.
Saphnelo and Infusion-Related Fatigue
Fatigue is one of the more frequently reported symptoms of a mild to moderate infusion-related reaction to Saphnelo. It typically occurs alongside other symptoms such as:
- Headache
- Nausea and/or vomiting
- Dizziness
- Fever, chills, or shaking
This post-infusion fatigue is generally different from the day-to-day exhaustion caused by lupus. It is acute, meaning it comes on suddenly around the time of the treatment, and is often short-lived, resolving within a day or two. This reaction is a sign that your body is adjusting to the medication. As treatment progresses, and your body becomes more accustomed to the drug, the severity and frequency of these reactions may decrease.
Differentiating Lupus Fatigue from Medication-Induced Fatigue
For those with SLE, it can be challenging to determine if fatigue is a result of the disease or a medication side effect. Below is a comparison to help distinguish between the two:
Managing Post-Infusion Fatigue
To help mitigate and manage the fatigue experienced after a Saphnelo infusion, there are several strategies patients can employ. These practices are designed to support the body's recovery and minimize the impact of the temporary side effect.
Pre-Infusion Preparation
- Prioritize a good night's sleep: Ensure you are well-rested before your infusion appointment. Starting the day with adequate rest can make a significant difference in how you feel afterward.
- Hydrate adequately: Drinking plenty of fluids, especially water, in the days leading up to your appointment can help prevent dehydration, which can worsen feelings of fatigue.
- Pre-medicate as instructed: Your doctor may recommend or prescribe certain medications, such as an anti-nausea drug, to be taken before your infusion to minimize the risk of a reaction.
- Eat a balanced meal: A light, nutritious meal before your infusion can help stabilize your energy levels and reduce the chance of nausea.
Post-Infusion Recovery Strategies
- Rest and relax: Plan to take it easy for the rest of the day after your infusion. Avoid strenuous activities and give your body time to process the medication.
- Stay hydrated: Continue to drink plenty of fluids post-infusion to help your body re-hydrate.
- Listen to your body: If you feel tired, allow yourself to rest. Ignoring fatigue can lead to exhaustion and a longer recovery time.
- Nap strategically: Short, well-timed naps can help without interfering with nighttime sleep. A brief 20-30 minute rest can be very rejuvenating.
- Communicate with your team: Inform your healthcare provider about any side effects you experience. They can offer further advice or suggest adjustments to your pre-infusion protocol.
When to Contact Your Doctor
While post-infusion fatigue is often mild, it is important to be aware of signs that may indicate a more serious issue. You should contact your doctor if you experience:
- Severe, persistent, or worsening fatigue that does not improve after a day or two.
- Symptoms of infection, such as fever, chills, cough, or painful urination.
- Signs of a serious allergic reaction, including swelling of the face, mouth, or tongue, breathing problems, fainting, or severe hives.
Conclusion
For patients with SLE, fatigue is a complex issue, and the addition of a Saphnelo infusion can add a layer of temporary, post-treatment tiredness. It is important to differentiate between the short-term fatigue of an infusion reaction and the ongoing exhaustion associated with lupus itself. By preparing for infusions, managing recovery effectively, and maintaining open communication with your healthcare team, patients can better cope with this side effect. Ultimately, while Saphnelo may cause some temporary tiredness, its goal is to reduce overall lupus disease activity, which can lead to a long-term improvement in energy levels for many patients.
For more information on Saphnelo and its role in treating systemic lupus erythematosus, refer to resources from the American College of Rheumatology.
| Feature | Saphnelo Infusion Fatigue | Chronic Lupus Fatigue |
|---|---|---|
| Onset | Acute (during or shortly after infusion) | Chronic (long-term, persistent) |
| Duration | Short-lived (typically 1-2 days) | Persistent, often daily |
| Associated Symptoms | Often accompanied by headache, nausea, dizziness | May be accompanied by muscle aches, joint pain, brain fog |
| Cause | An infusion-related reaction to the drug | Disease activity and inflammation from lupus |
| Improvement | Typically resolves as the infusion reaction subsides | Can improve with overall disease control, but may persist |
