The ideal approach to improve the outcome of SLE is to develop new drugs that are more disease specific, better tolerated and less toxic .although this has been the goal of several recent large, randomized prospective clinical trials, none of these trials was successful in demonstrating a better way to treat lupus nephritis. Thus for the foreseeable future, currently available drugs need to be used more effectively. it is conceivable that complete remission rates need to be improved and less toxic therapy would be needed if flares could be anticipated and presumptive treatment started.