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Objectives The management of SLE varies worldwide. Current SLE treatment goals focus on controlling disease activity and preventing flares and organ damage accrual. LupusNet is the largest federated data network in SLE that combines and harmonizes data from 5 existing registries to enable greater data consistency and enhance understanding of global clinical presentations and outcomes of SLE. This study assessed treatment patterns for patients with SLE, categorized by disease severity, from LupusNet and a US claims database.Methods Data from 3 SLE registries in LupusNet, APLC (Asia Pacific), RELESSER (Europe), and Almenara (South America), were analyzed from 2012 to 2024 using a privacy-preserving federated data network approach where only aggregated results were shared. Additionally, data from the US Merative MarketScan® Commercial Claims and Encounters (CCAE) Database from 2019 to 2024 were included in the analysis. In LupusNet, data from patients with >/=3 years of follow-up and >/=3 follow-up visits were collected and stratified into mild, moderate, or severe disease based on a SLEDAI score at Year 3 follow-up visit ( table 1). In the US claims database, data from patients who were diagnosed with SLE were stratified by mild, moderate, or severe disease based on documented symptoms and clinical features (table 1). Treatment exposures (ie, glucocorticoids, antimalarials, immunosuppressants, biologic therapies, and other immunosuppressants/immunomodulators) were assessed over follow-up.Abstract PO:07:186 Table 1Classification of disease severity in patients with SLE from LupusNet and the Merative MarketScan® CCAE DatabaseAbstract PO:07:186 Figure 1Results LupusNet included 3857 eligible patients (3070, mild disease; 637, moderate; 150, severe). US claims data included 49,350 eligible patients (23,461, mild disease; 16,172, moderate; 9717, severe). Overall, 63%-65% of patients with mild disease, 76%-84% with moderate disease, and 89%-95% with severe disease received glucocorticoids in LupusNet and US claims data ( figure 1). Antimalarials were frequently prescribed in 58%-66% of patients, regardless of disease severity. Use of immunosuppressants varied with disease severity: 25%-50% of patients with mild disease, 43%-67% with moderate disease, and 69%-81% with severe disease received immunosuppressants. Biologics and other immunosuppressants/immunomodulators were utilized less frequently across all disease severity levels in LupusNet (4% and 2%-4%, respectively), while the use of these therapies increased with disease severity in US claims data (8%-44% and 4%-13%, respectively); biologic use was primarily off-label rituximab.