Publications by authors named "Makan K"

The guidelines in this series provide evidence-based practical guidance for the diagnosis, treatment and follow-up of persons with inflammatory joint diseases. The purpose of these guidelines is to aid in shared decision-making between patient and physician, aiming to support high-quality clinical care. These guidelines have been prepared using the AGREE II instrument and based on adoption and, where appropriate, adaptation of international guidelines.

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Biologic and targeted synthetic disease-modifying antirheumatic drugs (b/tsDMARDs) target a specific pathway of the immune system, and are usually prescribed after failure of conventional synthetic disease-modifying antirheumatic drug therapy. The choice of b/tsDMARD depends on the disease profile and comorbidities, patient preference, registered indications of the drugs, and risks associated with therapy. It is recommended that b/tsDMARDs for immune-mediated inflammatory rheumatic diseases are prescribed by a rheumatologist, and all patients must be included in the South African Rheumatism and Arthritis Association biologic registry.

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Article Synopsis
  • - Early diagnosis and treatment of axial spondyloarthritis (axSpA) are crucial due to common issues of underdiagnosis and overdiagnosis, with South African guidelines offering methods for screening and useful investigations.
  • - A multidisciplinary approach to managing axSpA is recommended, focusing on lifestyle changes like exercise, smoking cessation, and psychosocial support.
  • - The ankylosing spondylitis disease activity score is suggested to track disease activity, alongside a stepwise therapy algorithm, and there is advice for screening comorbidities and ensuring vaccinations.
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Article Synopsis
  • Peripheral spondyloarthritis (SpA) consists of several types, including psoriatic arthritis, arthritis linked to inflammatory bowel disease, reactive arthritis, and undifferentiated SpA.
  • The South African guidelines provide insights on how to diagnose, assess, and treat peripheral SpA, highlighting the importance of teamwork among healthcare professionals.
  • A focus is placed on a "treat-to-target" approach, meaning treatment intensifies until minimal or very low disease activity is reached, and addressing related health issues (comorbidities) is crucial.
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Objective: To assess the unmet needs of South Africans with axial spondyloarthritis (axSpA) focusing on the patient journey, functional disability, and health-related quality of life.

Methods: One hundred forty-six South African axSpA patients completed the International Map of Axial Spondyloarthritis (IMAS) online survey. Patient journey, functional disability, activities of daily living, and psychological stress were analyzed in relation to socio-demographic characteristics, disease activity, diagnostic delay, extra-musculoskeletal manifestations, and drug therapy.

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Introduction Comorbidities in systemic lupus erythematosus (SLE) impact negatively on health-related quality of life (HRQoL) and life expectancy. We investigated the frequency and spectrum of comorbidities in privately insured South Africans with SLE. Methods The data of SLE patients based on International Classification of Diseases, Tenth Revision (ICD-10) codes and insured with Discovery Health Medical Scheme (DHMS), South Africa, aged ≥16 years at diagnosis and with ≥6 months of follow-up were reviewed.

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Introduction: Systemic lupus erythematosus has a predilection for women of childbearing age. Globally a shortage of rheumatologists exists resulting in general physicians and obstetricians treating systemic lupus erythematosus in pregnancy.

Methods: We conducted a survey amongst medical and obstetric registrars in South Africa to assess their subjective and objective competence in managing pregnant women with systemic lupus erythematosus.

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Management of ANCA-associated vasculitis (AAV) during the COVID-19 pandemic poses unique therapeutic challenges. An online survey was conducted to understand physician's choices for treating AAV during the COVID-19 pandemic. Web-based survey featuring nineteen questions was circulated amongst physicians across various specialties.

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Objectives: To develop recommendations for the management of rheumatic and musculoskeletal diseases (RMDs) during the COVID-19 pandemic.

Method: A task force comprising of 25 rheumatologists from the 5 regions of the continent was formed and operated through a hub-and-spoke model with a central working committee (CWC) and 4 subgroups. The subgroups championed separate scopes of the clinical questions and formulated preliminary statements of recommendations which were processed centrally in the CWC.

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Background: It is plausible that optimal cardiovascular disease (CVD) risk management differs in patients with rheumatoid arthritis (RA) from low or middle income compared to high income populations. This study aimed at producing evidence-based points to consider for CVD prevention in South African RA patients.

Methods: Five rheumatologists, one cardiologist and one epidemiologist with experience in CVD risk management in RA patients, as well as two patient representatives, two health professionals and one radiologist, one rheumatology fellow and 11 rheumatologists that treat RA patients regularly contributed.

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Background: Systemic lupus erythematosus (SLE) often has a profound negative impact on health-related quality of life (HRQoL). In the absence of any qualitative studies in sub-Saharan Africa, we undertook a study to explore living experiences, perceptions and unmet needs of South African patients with SLE.

Methods: Twenty-five women with SLE consented to participate in the study.

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Introduction: To investigate the prevalence and spectrum of comorbidities in South Africans with systemic lupus erythematosus (SLE).

Patients And Methods: A nested case-control study of a known alive group (AG) and deceased group (DG) of 200 and 40 patients, respectively, matched for age and sex, attending a tertiary Lupus Clinic. Comorbidities that were documented included, but not restricted to, those listed in the Charlson comorbidity index (CCI).

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