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Objectives The Lupus Low Disease Activity State (LLDAS) has been defined as requiring low values of SLE Disease Activity Index (SLEDAI-2K) and Physician Global Assessment (PGA) and predicts lower mortality and damage. The British Isles Lupus Assessment Group Index (BILAG-2004) is an alternative to SLEDAI-2K, incorporating more data. We developed and tested a modified form of LLDAS using BILAG-2004.Methods Demographic, clinical, treatment and laboratory data from 607 individual patients from the University College London Hospital SLE Cohort (2011-2024) were used to determine BILAG-LLDAS and SLEDAI-LLDAS state for each visit. SLEDAI-LLDAS was defined according to the original LLDAS definition, omitting the PGA criterion (<=1 (0-3)) due to lack of available PGA data. BILAG-LLDAS was defined as <3 stable/improving BILAG C scores in Haematological, Musculoskeletal or Mucocutaneous BILAG-2004 domains, serological activity allowed; prednisolone dose <=7.5mg/day, immunosuppressants and biologics allowed. Damage was reported according to Systemic Lupus International Collaborating Clinics/American College of Rheumatology Damage Index (SDI), at five-yearly intervals. BILAG-LLDAS and SLEDAI-LLDAS data were compared using descriptive statistics. Cox regression models and Kaplan-Meier curves were used to assess the predictive value of BILAG-LLDAS and SLEDAI-LLDAS for rates of flare, organ damage and mortality over time. Sensitivity analysis was conducted to assess the contributory value of PGA (<=1, (0-3)) to the BILAG-LLDAS and SLEDAI-LLDAS definitions, using prospectively collected PGA data over a six-month period.Results Of 10191 visits, 4458(43.7%) were in either SLEDAI-LLDAS and/or BILAG-LLDAS; 3593 visits were in both BILAG-LLDAS and SLEDAI-LLDAS (35.3%); 319 visits(3.1%) were in SLEDAI-LLDAS only; 535 visits(5.3%) were in BILAG-LLDAS only, and 5733 visits(56.3%) were in neither. Regression results are summarised in table 1. In the sensitivity analysis (n=395 visits), the PGA criterion altered the LLDAS status of three visits, two in SLEDAI-LLDAS only and one in SLEDAI-LLDAS and BILAG-LLDAS. The PGA score for the latter visit was later attributed to symptoms not due to SLE.Abstract PT7:05 Table 1Hazard ratios (HR) for flare, organ damage and mortality according to British isles lupus assessment group lupus low disease activity state (BILAG-LLDAS) and original LLDAS (SLEDAI-LLDAS)Conclusions BILAG-LLDAS performed similarly to SLEDAI-LLDAS in terms of protective associations with flare, organ damage mortality during follow-up in this single-centre cohort. Protection from damage may not have been demonstrated due to limited available data. The BILAG-LLDAS definition may obviate the requirement for a PGA criterion.