• Adverse events [ Time Frame: 48 weeks ]
• Mycophenolic acid trough levels [ Time Frame: 48 weeks ]
• MPA-area under the curve (AUC) 0-4 hour at 12 week [ Time Frame: 12 weeks ]
• C3 levels [ Time Frame: 48 weeks ]
• Urine IP-10 levels [ Time Frame: 48 weeks ]
• Anti-dsDNA [ Time Frame: 48 weeks ]
• Relapse free survival at 96, 144 and 240 week [ Time Frame: 96, 144 and 240 weeks ]
• eGFR at 96, 144 and 240 week [ Time Frame: 96, 144 and 240 weeks ]
• Progression to CKD stage 3 or more at 96, 144 and 240 week [ Time Frame: 96, 144 and 240 weeks ]
• End stage renal disease at 96, 144 and 240 week [ Time Frame: 96, 144 and 240 weeks ]

• Placebo Comparator: FD arm
  MMF will be prescribed at a starting dose of 1.5 g/day and increased to 2 g/day at week 4 (if body weight ≥ 45 kg) and continue the same dose until week 24. After week 24, MMF will be lowered to 1.5 g/day.
  Intervention: Drug: Mycophenolate Mofetil
• Active Comparator: CC Arm
  MMF will be prescribed at a starting dose of 1.5 g/day. MPA-C0 (trough) level will be measured weekly and MMF dose will be increased by 500 mg/day every week until the MPA-C0 level ≥ 3 mg/L or the MMF dosage is 3000 mg/day. After achieving the targeted MPA-C0 level, the MMF dose adjustment will be allowed only if the MPA-C0 levels are lower than 3 mg/L for two consecutive monitoring visits. After week 12, MMF will be maintained at the same dose until week 48
  Intervention: Drug: Mycophenolate Mofetil

Inclusion Criteria:

• Age 18-65 year
• Diagnosis of SLE according to ACR criteria. At least 4 criteria must have been present for the diagnosis of SLE

• Active lupus nephritis (both new and flare patients can be included) defined as:

  • Within 16 weeks of randomization, had Biopsy-proven ISN class III or IV [exclude III(c), IV-S(c) and IV-G(c). Patients are permitted to have co-existing class V and
  • At screening day, has urine protein creatinine ratio (UPCR) or 24-hour urinary protein ≥ 1.0 g/g or g/day

Exclusion Criteria:

• Pregnancy or breast feeding
• Child-bearing age women who refuse to use effective birth-control
• Poor compliance
• Estimated-GFR < 20 mL/min/1.73 m2
• Crescentic glomeruli more than 30 percent
• Severe extra-renal involvement of SLE
• History of severe allergic reactions or adverse effects to MMF
• Uncontrolled concomitant disease
• Known active, clinically significant infection of any kind
• History of serious recurrent or chronic infection
• History of malignancy (except basal cell carcinoma, squamous cell carcinoma of the skin or carcinoma in situ of the cervix that has been excised and cured)
• Concomitant conditions which has required treatment with systemic corticosteroid (excluding topical or inhaled steroids) at any time in the 52 weeks prior to screening
• Treatment with more than 1 g cyclophosphamide within the past 24 weeks
• Receipt more than 3 g of IV pulse methylprednisolone within the past 12 weeks
• Receipt prednisolone more than 30 mg/day for longer than 30 days within the past 12 weeks
• Treatment with MMF at ≥ 1.5 g/day for over 4 weeks within the past 12 weeks
• On treatment with Tacrolimus or Cyclosporine on the day of screening
• Treatment with any biologic B-cell depleting therapy (e.g. anti CD-20, anti CD 22) within 52 weeks

• Receiving concomitant medication interfering PK of MPA

  • Cholestyramine
  • Rifampin