Systemic lupus erythematosus (SLE) can follow an unpredictable course and be either chronic or of a relapsing and remitting form. Current measures used to assess disease activity do little to help physicians predict disease flares or complications that may arise. There are serious musculoskeletal, renal, cardiovascular, and ocular effects associated with SLE and the majority of these adverse consequences are associated with the use of the corticosteroid prednisone in these patients. Pulsed-dose methylprednisone treatment during flares appears to carry less risk than increasing daily prednisone doses. However, medication that can lessen or eliminate steroid use in moderately affected patients is needed.