Head of Division: Professor Asgar Ali Kalla
The Division of Rheumatology has several research interests relating to different aspects of the rheumatic diseases. Osteoporosis is an area of interest for many years and there is ongoing collection of longitudinal bone mineral density data in patients with rheumatoid arthritis (RA) and systemic lupus erythematosus (SLE). Age-related bone loss at different skeletal sites is being prospectively studied in collaboration with the Department of Nuclear Medicine and the Endocrine Unit. Recently, collaborative studies with the Division of Hepatology have been carried out to see the relationship between bone mineral density (BMD) and auto-immune hepatitis. Clinical drug trials are in progress to study the safety and efficacy of the newer biological DMARDs in RA and SLE.. Recently, the trials of coxibs are concentrating on cardiovascular outcomes to a greater extent than their gastr-toxicity. We have also been looking at SLE genetics in collaboration with the Hepatology, with particular reference to the Vitamin D receptor and its role in the pathogenesis of auto-immune diseases. Newer areas of research include the study of chronic tophaceous GOUT; community aspects of diagnosing and treating rheumatic diseases at CHCs; early rheumatoid arthritis; genetics of bone loss in SLE; and functional problems in ankylosing spondylitis. The rheumatic diseases unit provides inpatient and outpatient rheumatology services for the entire Western Cape region. Sessions are carried out at the Heideveld and Khayelitsha Community Health Centres 6 times a year. We have recently extended the service to Guguletu CHC as well. Training is provided on a continuous basis for medical students, allied health professionals, a medical officer, two rotating medical registrars and two career registrars. Research is largely clinically orientated, but a laboratory-based approach is being used to study the genetics of SLE and the differentiation between flares and infection in SLE patients. Family studies have also been started in patients with SLE and RA. In addition, there is significant involvement in clinical drug trials in rheumatoid arthritis, systemic lupus erythematosus and osteoarthritis.