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Objectives To describe the characteristics and clinical outcomes in SLE patients initiating anifrolumab after its commercialization in Spain.Methods Observational retrospective and longitudinal chart review study including SLE patients who initiated anifrolumab during June 1st, 2023 and up to May 31st, 2024. Index date was the date of the first anifrolumab infusion. Baseline data from 12 months prior to the initiation of anifrolumab and follow-up every 6 months until the end of the study (December 31st, 2024) were collected. Inclusion criteria were: SLE diagnosis according 2019 EULAR/ACR, aged 18 years or older at the index date, anifrolumab initiation between June 1st, 2023 and May 31st, 2024 and medical records of 12 months prior to anifrolumab. Continuous variables were reported by mean and standard deviation (SD) while categorical variables were reported by absolute and relative frequencies.Results Data from 152 patients from 20 Spanish centers were included. At index date, mean (SD) age was 47.4 (12.5) years; 88.2% were female and mean (SD) time from SLE diagnosis was 12.3 (9.0) years. Main domains affected were mucocutaneous (80.8%), articular (69.5%), immunological (47.7%) and hematological (31.1%). Disease activity measured as SLEDAI-2K, showed reduction over time, from mean (SD) 7.49 (4.39) at index date, to 3.70 (4.43) at month 6 and 2.96 (4.38) at month 12. Percentage of patients with low SLEDAI-2K and no clinical SLEDAI=0 varied notably after 12 months of treatment ( figure 1). Overall corticosteroid use decreased from 68.7% at baseline to 63.2% at month 6 and 57.1% at month 12 of follow-up. Notably, the proportion of patients with corticosteroid dosage over 5 mg/day declined from 29.6% to 14.3% after 12 months. Organ damage, reported by SDI score, ranged from mean (SD) 1.06 (1.55) at index date, to 0.80 (1.33) at month 6 and 0.65 (1.14) at month 12 of follow-up.Abstract PO:07:196 Figure 1Disease activity in SLE patients included in AZAHAR study at the index date (first anifrolumab infusion) and during follow-up.Conclusions SLE patients initiating anifrolumab in real-world practice showed reduction in disease activity and corticosteroid use after 6 months of treatment, and consistently after 12 months. These findings suggests that anifrolumab could reduce organ damage accumulation, supporting the potential benefit of anifrolumab in achieving fast and sustained control of the disease.