Abstract: Ｏｂｊｅｃｔｉｖｅ：To discuss the shortterm clinical efficacy and safety of belimumab combined with standard therapy in treatment of severe active lupus nephritis(LN).
Ｍｅｔｈｏｄｏｌｏｇｙ：2 patients with severe active LN who were dignosed and treated in the National Clinical Research Center of Kidney Disease were prospectively observed.They accepted belimumab in combination with standard therapy for 24 week. The disease outcome and clinical medication of 2 patients were evaluated.
Ｒｅｓｕｌｔｓ：Two patients with LN observed in this study were female and newly diagnosed, the age was 22 and 27 years old respectively, SLEDAI were 15 and 17, and the pathological types of LN were IVG (A) (AI 13,CI 0) and IVG (AI 12,CI 0). Both patients received methylprednisolone pulse(MP) therapy (25g, 15g), followed by oral prednisone (45 mg／d, 30 mg), and received multitarget therapy or mycophenolate mofetil (MMF) as induction therapy. Both patients started beilimumab regimen(10mg／kg infuse on weeks 0,2,4,then every 4 weeks until weeks 24) within 2 weeks after MP. After 24 weeks of treatment, 1 case achieved complete renal remission, SLEDAI decreased to 2 (complement C3 0593 g／L), 1 case achieved partial renal remission, and SLEDAI decreased to 8 (proteinuria 078 g／24h, urinary sediment red blood cell count 158／HPF). To the week 24, dosage of prednisone in the two patients was reduced to 15 mg and 10 mg respectively, and there was no infection or deterioration of renal function.
Ｃｏｎｃｌｕｓｉｏｎ：Belimumab combined with standard therapy is effective in treatment of adult severe active LN. The scores of SLEDAI and renal damage are relieved obviously, and oral prednisone can be reduced to a lower dose.

Key words: systemic lupus erythematosus, lupus nephritis, belimumab