As a general guideline,steroids are necessary in acute episodes of SLE-but prolonged use has to be juidicious in view of brain hemmorhage, menorraghia history of Ms. Kaur Now since shehas more of arthritic syptoms,her rheumatologist may think of substituting steroids with other biologics as and if affordable, as the price is enormous of certain biologics. ---Well your treating rheumatologist is the best judge. Personally, I would now substitute steroids with non biologic disease modifying anti-rheumatic drugs (DMARDS) Certain periodic blood tests are conducted before starting these,seeing past complications of SLE disease treated with steroids. (sometimes steroids are life saving in acute emergencies and are definitely indicated for treatment of SLE, so giving steroid may have been inevitable in Ms. Kaur s case) If the patient can visit rheumatologists at AIIMS New-Delhi, it would be worth seeking an opinion.