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Objectives To evaluate the association between disease activity and the Patient Acceptable Symptom State (PASS) and to identify clinical and socio-demographic correlates of PASS in systemic lupus erythematosus (SLE).Methods We analyzed data from the large multicenter RELESSER registry (39 Spanish centers). PASS was self-assessed as acceptable (PASS-A) or non-acceptable. Collected variables included socio-demographics (age, sex, employment, educational attainment) fibromyalgia, disease activity (SLEDAI-2K), DORIS-remission (DORIS-R) and LLDAS achievement, disease damage (SLICC/ACR damage index (SDI), current therapies and the Lupus Impact Tracker (LIT) items. Univariable and multivariable logistic regression were performed. Models were run with clinical covariates and LIT items. A sub-analysis was carried-out in patients being in DORIS remission.Results Among 1,249 patients (90% women; mean age 48.2 years), 72% reported being PASS-A. Lower disease activity (SLEDAI-2K OR 0.95, 95% CI 0.92–0.99), DORIS remission (OR 2.48, 95% CI 1.87–3.82) and LLDAS (OR 2.60, 95% CI 1.91–3.54) were associated with higher PASS-A probability. Being employed was positively associated, while female sex, fibromyalgia and current glucocorticoid use were negatively associated with PASS-A. When LIT items were included in de models, SLEDAI-2K lost significance, while DORIS-R (OR 1.49, 95% CI 1.10–2.03) and LLDAS (LLDAS OR 1.84, 95% CI 1.33–2.55) remained associated though attenuated. Pain/aching, limitations due to pain/fatigue, family-role limitations and anxiety were the strongest independent barriers to PASS-A ( table 1). Among the 628 patients in DORIS-R, 20% were not in PASS-A; female sex (OR 0.34, 95% CI 0.12–0.97) and fibromyalgia (OR 0.37, 95% CI 0.17–0.78) remained negative determinants, whereas higher education (OR 2.48, 95% CI 1.56–3.98) and employment (OR 1.90, 95% CI 1.16–3.11) were positively associated with PASS-A. Within this subgroup, pain, fatigue-related limitations and anxiety remained the main barriers to perceiving an acceptable symptom state.Abstract PT7:06 Table 1Assoiation between disease activity state, as measured by SLEDAI-2K, DORIS and LLDAS, and being in PASS acceptable after including fibromyalgia or the LIT items in the modelsConclusions DORIS remission and LLDAS are associated with PASS acceptable response. Pain, fatigue and anxiety prevent many SLE patients from achieving satisfactory health beyond disease remission. 20% of SLE patient in DORIS remission are still not in PASS acceptable. PASS assessment may help revealing unmet needs in SLE management.