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Objectives Glucocorticoids (CG) use is a main driver of organ damage progression in Systemic Lupus Erythematosus (SLE). Updated EULAR SLE recommendations suggest avoiding the chronic use of CG or, if necessary, to employ dosages < or = 5 mg of prednisone/day. However, the impact of low dosages of GC on organ damage accrual is not well known.To assess the chronic use of GC and relationship with organ damage in a large, multicentre SLE prospective cohort.Methods Patients with SLE (ACR-1997 criteria) enrolled in RELESSER-PROS registry, completing up to 5 annual visits. Sociodemographic characteristics, activity (S-SLEDAI and PGA (0-3), organ damage (SLICC/ACR Damage Index) (SDI), treatments and prednisone dosages for every visit were collected.We compared patients never used GC during the whole follow-up (group 1), patients using <5mg/day all the time (group 2) and patients using > 5 mg any time (group 3), in terms of SDI delta (V5-V1). Variables were analysed by GC dose group using Chi-square or Fisher tests for categorical variables, and ANOVA or Kruskal-Wallis for continuous variables depending on normality.Results A total of 1463 were included. Baseline characteristics: Mean age: 56.1 (DS±13.6) years, 90% female and 94.1% Caucasian. Mean duration of the disease: 12.7 (8.77) years. Median (Q1,Q3) SLEDAI 2 [0, 4] and PGA 0.3 [0, 0.9]. Median SDI: 1.00 [0, 2.00]. SDI >0: 63.3%. Treatments: antimalarials 54,2%, GC 50.6%, methotrexate 10.1%, mycophenolate 13.1%, azathioprine 12.7%, belimumab 4.2% and rituximab (4.5%).Distribution of GC use and doses at each visit are shown in table 1. Comparative organ damage by GC dose group is provided in table 2. Interestingly, patients treated with GC sustained dose < or = 5mg didn’t accumulate more damage (Delta of SDI), as compared with patients who did not receive GC at any time. The comparations were adjusted for age, duration of disease and SDI at baseline (table 2).Abstract PO:10:258 Table 1–2Conclusions According SDI, patient who received more than 5mg/day of GC anytime throughout the study develop more organ damage than patients without GC or 5mg/day or less; however, not differences in damage progression were found between 5mg/day or less and not using GC at any time.