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Objectives Background: Belimumab (BLM) is a monoclonal antibody that inhibits B-lymphocyte stimulating factor (BlyS), approved in 2011 as a treatment for systemic lupus erythematosus (SLE). We present the experience with BLM in monotherapy in this spanish cohort.Objectives To describe demographic characteristics, effectiveness and safety of BLM in monotherapy (Mono) since its approval in SLE and compare them with SLE cohort of patients treated with BLM in combination (Combo).Methods Descriptive, retrospective, multicenter study in patients diagnosed with SLE according to EULAR/ACR 2019, SLICC and/or ACR 1997 diagnostic criteria treated with Belimumab in monotherapy. Data were collected from medical records of SLE patients treated with BLM since 2011. BLM monotherapy was defined as patients receiving BLM without cDMARD and/or hydroxychloroquine.Results Fifty-eight patients received BLM in monotherapy. Baseline characteristics are summarized in table 1. Comparing with Combo patients, Mono patients had more skin involvement and received less treatment with antimalarials before BLM begins. It was found a trend in having less proportion of antiDNA positive antibodies and less use of cDMARD previous to BLM begins. Of the 58 patients with BLM monotherapy, 69.6%, 69.2%, 71.4% and 48.1%, respectively, showed hematological, renal, joint, and cutaneous improvement. A total of 22 patients (37.9%) discontinued treatment, of which 59.1% were due to ineffectiveness. Although more patients stopped BLM in the Mono group we found that the remaining patients in this group had a better survival of BLM when we compare them with Combo group.Abstract PO:12:318 Table 1Descriptive data of patients according to BLM in monotherapyConclusions BLM in monotherapy seems to be a good choice for patients with SLE specially in those patients who are intolerant or ineffective to HCQ, cDMARDs and/or bDMARDs.