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Objectives Studies on sex differences in SLE have focused primarily on clinical presentation and disease activity. However, data on differences in comorbidities is limited (1). Our study demonstrates the impact of gender differences on organ involvement in lupus and the differences in comorbidities.Methods The present study documented 554 SLE patients between January (2015 -2025) according to the ICD-10 diagnosis code. A review of patients‘ files was undertaken by two rheumatologists from the hospital’s electronic records system. SLE patients who met the 1990 American College of Rheumatology (ACR) and/or Systemic Lupus International Collaborating Clinics (SLICC) criteria were included in this study.Patients with missing follow-up and treatment data were excluded from the study. The patients‘ demographic, clinical, serological data and treatment histories (steroid, hydroxychloroquine, immunosuppressives) were documented. Comorbid diseases were documented, including hypertension, diabetes mellitus (DM), dyslipidaemia, coronary artery disease (CAD), cerebrovascular events, chronic obstructive pulmonary disease, malignancy, autoimmune hepatitis, autoimmune thyroid diseases, osteopenia/osteoporosis, and chronic kidney disease (CKD).Patients were divided into two groups based on gender, and demographic, clinical, and history of treatment variables were compared.Results Of the patients included in the study, 87 (20%) were male, and the mean age at diagnosis was 37.2 (12.3) years. Male lupus patients had a higher frequency of fever, serositis, and subacute/acute cutaneous lupus ( table 1). Thirty-one (35.6%) of male lupus patients had a biopsy-confirmed diagnosis of lupus nephritis, which was statistically higher than in females (p=0.002). Secondary AFAS was present in 35 (40.2%) male lupus patients, and the prevalence was higher than in female lupus patients (p<0.001). Male lupus patients used mycophenolic acid and cyclophosphamide for treatment at a higher rate than female lupus patients (p=0.02 and p=0.004, respectively). Hypertension, CAD and chronic renal failure were more common in male lupus patients (p=0.042, p=0.027, p=0.003).Abstract PO:09:227 Table 1Comparision of clinical and demographic features of patients according to sex differencesAbstract PO:09:227 Figure 1Selection of SLE patients. * Exclusion criteria: Patients who do not meet the 1990 American College of Rheumatology (ACR)and/or Systemic Lupus International Collaborating Clinics (SLICC) SLE criteria; patients with missing follow-up visits and history of treatmentConclusions Male lupus patients are more likely to present with clinically significant renal involvement, thrombosis and AFAS. The prevalence of comorbidities is higher in male patients. In the context of daily rheumatology practice, clinicians must be aware of gender-specific risks and know how to screen for comorbid diseases. This knowledge will help them to prevent organ damage in patients.