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Objectives Patients with Systemic Lupus Erythematosus (SLE) often experience impaired health-related quality of life (HRQoL) influenced by disease burden and physical dysfunction. Our study aimed to investigate the relationship between upper limb function and HRQoL in patients with SLE.Methods A total of 240 patients with SLE fulfilling the 2012 SLICC classification criteria and 122 age- and sex-matched healthy controls were enrolled. Upper limb function was evaluated by grip and pinch strength measurements and the Purdue pegboard test for dexterity. Activities of daily living (ADLs) were assessed using the Disabilities of the Arm, Shoulder and Hand (DASH) questionnaire. HRQoL was measured using the Lupus Quality of Life (LupusQoL) instrument. Associations between upper limb function, ADLs, and LupusQoL domains were examined using univariate and multivariate linear regression models adjusted for demographic, clinical, and treatment variables.Results Patients with SLE exhibited significantly reduced grip and pinch strength and lower dexterity compared to healthy controls (all p<0.05). In univariate analyses, all upper limb function measurements and DASH scores were significantly correlated with all LupusQoL domains (p<0.05). Multivariate regression analysis demonstrated that reduced grip strength and impaired dexterity were independently associated with poorer scores across all LupusQoL domains (p<0.05) after adjustments for disease activity, damage, medications, fibromyalgia, and visual analogue score, except for Body Image domain in relation to the Purdue test. DASH scores were also inversely associated with all LupusQoL domains (p<0.001), confirming the relationship between upper limb dysfunction and diminished HRQoL ( table 1).Abstract PO:13:334 Table 1Conclusions Upper limb dysfunction and impaired ADL performance are prevalent in SLE and independently associated with poorer HRQoL across all LupusQoL domains, irrespective of disease activity or damage. Incorporating upper limb assessment into routine clinical care and implementing targeted exercise interventions could enhance physical function and improve quality of life in patients with SLE.