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Objectives The concept of disease modification (DM) was recently introduced to improve the long-term care of patients (pts) with SLE. To claim DM ultimately requires delayed/prevented progression of organ damage beyond 5 years. The concept of DM is valuable for assessing ‘whether an intervention is on track for achieving DM at the 5-year mark,’ based on interim evaluations during the first 5 years. Latin American pts with SLE are prone to poorer outcomes, which are associated with disease severity and social determinants of health (SDH). We evaluated the prevalence of extrarenal DM in Latin American pts with SLE and examined SDH and treatment based on achievement of extrarenal DM.Methods GLADEL 2.0 included adults who fulfilled 1982/1997 ACR and/or 2012 SLICC classification criteria for SLE (43 centers; 10 Latin-American countries). Composite definition of DM for extrarenal SLE: (i) significant reduction in SLEDAI (>3 points), (ii) no severe flares, and (iii) <=10 mg/day prednisone for months 0–12 and <=5 mg/day prednisone-equivalent for years 2–5. Pts with complete data at baseline, 12, 24, 36, 48, and 60 months were analyzed.Results Among 1083 pts in the cohort, 709 had baseline data needed to fulfill DM criteria. Table 1 shows differences in demographics and SDH by extrarenal DM achievement groups over time. Although educational attainment varied between groups and genders at each time point, higher proportion of pts achieved DM among men compared to women at 36 and 48-months. The proportion of pts achieving DM criteria ranged between 16%–20% across time points (figure 1a). Figure 1b shows DM trajectories during follow-up. Medication exposure is depicted in figure 2. A higher number of pts achieving extrarenal DM at months 36 and 48 received cyclophosphamide.Abstract PT3:01 Figure 1–2Abstract PT3:01 Table 1Sociodemographics and their differences among patients with SLE who did and did not achieve extrarenal disease modification over timeConclusions Up to 20% of Latin American pts with SLE achieved extrarenal DM. The study highlights critical disparities; pts with lower educational attainment and women were less likely to achieve DM. Specific medication exposure may play a significant role in extrarenal DM achievement, particularly cyclophosphamide. These results underscore the importance of addressing SDH and tailoring treatment strategies to improve outcomes for marginalized groups within this population.