My rheumatologist does mine every six months. My tests show that the lupus is active but not at the level when I had a flare in 2009. After cytoxin treatment in 1998, my markers where silent until the flare in 2009.
Like I said now their active but basically at the same level.My rheumatologist says he goes by how you feel not by the markers because the disease is so difficult to treat.

I have had mine test positive and then all at once test negative . I really think it just depends on if you are having a flare up or not. I have a really good Dr and she goes by what she sees and what I say much more than the blood tests. I have had other Dr's that went solely on the blood tests and really didn't listen to what I had to say. The Ana is a good starting point for them to start looking for a problem (kinda like a check engine light on a car) but it doesn't tell them everything. Some people test positive all the time and others like me, test positive only during a flare.

My understanding is that the ANA usually stays positive once positive but can become negative with treatment.

I think it is more common for the ESR/ CRP to raise with flares, but even that I think is misleading and people with active SLE can have them normal. Also, I think that protein in the urine and severe low blood counts could be a flare. I would think looking at the titier could maybe be an indication as someone that had an ANA of 1:640 and is now at at 1:80 might be more headed to remission than flaring. Ultimately, I think a good rheumatologist will go by symptoms and not just labs.

When I was tested for Lupus I was not in the middle of a flare up. And when I was having a flare up and tested results fluctuated.

ANA is just anti-nucular antibodies. It means nothing. The absolute test for lupus is an anti double strand DNA test. An ANA will come back positive for any titer..RA, LYME.
AND just some joint pain.