Are you eligible to enroll?

Answer the following questions to discover if you are eligible to enroll in the Lactation Study. This should take no more than 10 minutes to complete.

Are you aged 18 years or older?

Yes

Are you a resident of the United States?

Yes

Are you currently taking SAPHNELO^™ (anifrolumab) for lupus?

Yes

Are you planning to take SAPHNELO^™ (anifrolumab) for lupus?

Yes

Are you breastfeeding and planning to continue feeding your infant only breast milk (via breast or pumping) for at least 30 days?

Yes

Are you pregnant and planning to breastfeed your infant only breast milk (via breast or pumping) for at least 30 days?

Yes

Your baby was born at 32 weeks of gestation or after?

Yes

Your baby had an average weight at the time of birth?

Yes

I don't know

Your baby has an average weight now?

Yes

I don't know

Thank you for confirming your eligibility to enroll!

Please complete the form below and a study team member will contact you with more information about participating in the Study.

Contact request form

Complete this form and a study team member will contact you with more information about participating in the Study.

* marks required field.

Name*

Email*

Primary Phone Number*

Alternate Phone Number

Please select your preferred method of contact:

Email
Phone
No preference

We are here to speak with you Monday to Friday from 8:00 am to 8:00 pm EST.

Please identify the best day(s) for contact. You can select as many as you wish.

Monday

Tuesday

Wednesday

Thursday

Friday

Please identify the best time(s) for contact. You can select as many as you wish.

8:00 am - 12:00 pm

12:00 am - 5:00 pm

5:00 pm - 8:00 pm

I authorize the Anifrolumab Breastfeeding Study to contact me and/or leave a message for me at these numbers or to contact me via email at the address listed below.

I agree to the study referencing the Anifrolumab Breastfeeding Study in messages or emails.

Privacy Statement:

Pharmaceutical Product Development, LLC. (PPD) respects your privacy and understands that it is important to you. The information you provide on this form will be used to contact you for the purposes of assessing your eligibility to participate in the Anifrolumab Breastfeeding Study. This information will be held by PPD and not shared with the study sponsor (AstraZeneca) or any other third party without your permission. In the event you choose not to enroll, the study team will request permission to share your contact information with AstraZeneca. In order for them to contact you for safety follow up about your pregnancy. If you do not provide permission, and do not enroll in the Study your contact details will be deleted.