Objective. To evaluate the efficacy of long-term treatment with cyclosporin A (CSA) in systemic lupus erythematosus (SLE). Methods. Thirty patients with SLE whose condition was either poorly responsive or unresponsive to treatment with steroids and/or cytotoxic drugs were enrolled in a prospective, nonrandomized study of CSA, Patients with hypertension or hypercreatinemia were excluded, Disease activity was evaluated according to the systemic lupus activity measure, Assessments were made prior to study entry and after 6, 12, 18, and 24 months. Results. Twenty-seven patients completed at least 24 months of treatment with CSA, The mean disease activity score significantly decreased after 6 months of therapy (P