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Objectives The aim of this study was to assess the impact of antiphospholipid antibodies (aPLs) on the evolution of systemic lupus erythematosus (SLE) disease manifestations other than thrombosis and pregnancy-related morbidity.Methods The study population consisted of a previously reported SLE cohort 1 fulfilling the 2012 SLICC criteria with extended follow-up. After an initial screening and cohort establishment between 2014 and 2016, medical records of each patient were evaluated retrospectively for disease manifestations, and patients were prospectively followed up (figure 1). Accumulation of clinical features and SLICC/ACR Damage Index (SDI) were compared in patients with and without persistently positive for aPLs (anti-cardiolipin IgG and IgM, anti-beta2glycoprotein I IgG and IgM, and lupus anticoagulant).Results 295 patients with SLE were screened between 2014 and 2016. After exclusion of patients with incomplete information and those who were lost to follow-up, 248 were included in the study. 223 (89.9%) were female. The mean age and disease duration during the screening period were 43.1±11.3 and 9.6±6.5 years, respectively. The median prospective follow-up was 9.5 years. 50 (20.2%) had persistently positive aPLs and 26 (10.5%) were classified to APS. At the initial presentation, the frequency of constitutional, musculoskeletal, and renal manifestations was similar in patients with and without aPLs, while aPL-positive patients had more frequent neuropsychiatric, serosal, and hematological involvement but less mucocutaneous features ( figure 1). However, renal and musculoskeletal involvement accumulated significantly more in aPL-positive patients during follow-up. An earlier accumulation pattern was most prominent for neuropsychiatric and hematological involvement in aPL-positive patients. The OR of an overall damage score (SDI) of 3 or more in aPL-positive patients was 4.29 (1.19-15.45) even at the initial presentation. The median time to reach an SDI score of 3 or more was 2.5 and 10.4 years in patients with and without positive aPLs, respectively.Abstract PO:01:022 Figure 1Conclusions aPLs have an impact on the evolution of SLE features other than APS. Damage occurs earlier in SLE patients with positive aPLs.Reference Ilgen U, Yayla ME, Ates A, et al. Antiphospholipid antibodies and non-thrombotic manifestations of systemic lupus erythematosus. Lupus. 2018;27:665–9.