This is an important study done by recognized lupus experts. The question that I have is if all the SLE patient's who had sera tested were ANA positive at time of their original diagnosis. If so, then the question is at the time their sera was tested for this study, what treatment were they on and how active was their lupus. This was not included in this study. We have all had SLE patients who are well controlled on therapy and their ANA becomes negative. In my opinion, ANA negative patients either do not have SLE or are extremely well controlled on therapy and should not be included in lupus trials. Dr. Pisetsky does make a good point that all ANA assays are not equal in quality.