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Objectives Sustained drug-free remission may be the ultimate goal for patients with SLE; however, the probability of achieving it and predictors thereof have not been fully evaluated.Methods We studied SLE patients in a long-term longitudinal, multinational, multiethnic inception cohort; eligible patients were those who attended >1 annual visits and who were not in remission at the baseline visit. Sustained drug-free remission was defined as a SLEDAI-2K (excluding serology)=0, off prednisone and immunosuppressive drugs (IS) but antimalarials were allowed. Possible predictors included were sex, age at diagnosis, ethnicity, educational level, SLEDAI-2K domains at cohort entry, baseline disease duration, highest prednisone dose before baseline, prednisone dose at baseline, number of methylprednisolone (MP) IV pulses as well as the mean dose per pulse, IS and antimalarials at or before baseline. Univariable and multivariable Cox regression models (stepwise selection procedure, alpha to stay in the model of 0.05) were used. Model 1 assessed sustained drug-free remission for at least two years as the outcome, model 2 sustained drug-free remission for at least three years and model 3 for at least five years. Patients who achieved the indicated period of sustained remission but later lost it were included in the analysis.Results 959 patients were studied; the probability of achieving sustained remission for at least two years at five and 10 years were 4.4% and 16.9%, respectively. Black, Asian and Hispanic ethnicities were associated with a lower probability of remission in all three models; Caucasian ethnicity not from North America and age at diagnosis were associated with a higher probability of remission in models 1 and 2; the association with age appeared linear and not bimodal; renal involvement and anti-dsDNA were negatively associated with remission in model 1; baseline MP IV pulses and azathioprine use were negatively associated with remission in model 2. Higher daily baseline prednisone dose was negatively associated with sustained remission in model 3. All results are summarized in table 1.Abstract S7:04 Figure 1Probability of achieving sustained drug-free remission for at least two years per ethnic groupAbstract S7:04 Table 1Predictors of sustained drug-free remission for at least two, three and five years. Multivariable modelsConclusions Sustained drug-free remission in SLE is uncommon but not rare, and is predicted by sociodemographic characteristics and disease severity. Further studies are needed to determine the impact of new treatments on this outcome.