For 50 years Cyclophosphamide was the main drug for Systemic Lupus Erythematosus (SLE) therapy. SLE is a connective tissue disorder that involves many organs. Despite it became a chronic disease, it is still now a killing disease that usually arises in young women. Belimumab is a new drug approved for SLE treatment. It blocks plasma free cytokine BAFF involved in B cell lymphocyte activation. This treatment result as decreasing in disease severity as well as a reduction in steroids usage. We enrolled in Belimumab treatment three patients with a mild to severe disease evaluated with SLE activity index (SLEDAI). All these three patient were non responsive to other treatments and have to take prednisone more than 15 mg per day. Before starting treatment, they referred fatigue and joint pain.No severe renal disease was found. Patients presented a decrease of symptoms, an increase in physical activity with a reduction of disease severity, as confirmed by a reduction of >4 points in SLEDAI score. Prednisone was slowly reduced to 7.5 mg per day or less. No grade 4 toxicities have been found. In the longest follow-up patient hepatic steatosis was revealed.
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