n South African Medical Journal - Musculoskeletal disorders - disease burden and challenges in the developing world : CME - guest editorial

Volume 105, Issue 12
  • ISSN : 0256-9574
  • E-ISSN: 2078-5135



Recent advances in rheumatology have contributed to elucidate the complex pathogenic processes that underlie the development and progression of rheumatic diseases. This has led to the advent of new therapies to treat these conditions, including the biologic therapies. The use of synthetic disease-modifying anti-rheumatic drugs (DMARDs) together with biologic therapies has increased dramatically across a range of diseases, and resulted in improved outcomes for patients. In a study done in Spain, the overall age-standardised mortality rate for systemic lupus erythematosus (SLE) increased during 1981 - 1999 and stabilised during 2000 - 2010. The mean age at death increased with time, from 42 years in 1981 to 61 years in 2010. Similar mortality trends have been observed in patients with rheumatoid arthritis (RA), even though mortality still remains higher in RA patients compared with the general population. The overall SLE survival rates have increased significantly between the 1950s and 2000s, from 74.8% to 94.8% and 63.2% to 91.4% for the overall 5-year and 10-year survival, respectively. These improved outcomes are thought to be due to a combination of earlier recognition of mild disease and better approaches to therapy.

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