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Managing rheumatic and musculoskeletal diseases — past, present and future


Progress in rheumatology has been remarkable in the past 70 years, favourably affecting quality of life for people with rheumatic and musculoskeletal diseases. Therapeutics have advanced considerably in this period, from early developments such as the introduction of glucocorticoid therapy to the general use of methotrexate and other disease-modifying agents, followed by the advent of biologic DMARDs and, most recently, small-molecule signalling inhibitors. Novel strategies for the use of such agents have also transformed outcomes, as have multidisciplinary nonpharmacological approaches to the management of rheumatic musculoskeletal disease including surgery, physical therapy and occupational therapy. Breakthroughs in our understanding of disease pathogenesis, diagnostics and the use of 'big data' continue to drive the field forward. Critically, the patient is now at the centre of management strategies as well as the future research agenda.

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Figure 1: A timeline summarizing the evolution of treatment for rheumatoid arthritis.
Figure 2: A timeline summarizing the development of diagnostic tools in rheumatology.


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G.R.B.'s research work is supported by the German Science Foundation and the Federal Ministry for Education and Research.

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All authors researched data for the article and made substantial contributions to discussions of content, writing and review/editing of manuscript before submission.

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Correspondence to Gerd R. Burmester.

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Burmester, G., Bijlsma, J., Cutolo, M. et al. Managing rheumatic and musculoskeletal diseases — past, present and future. Nat Rev Rheumatol 13, 443–448 (2017).

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