Since the first description of the bimodal mortality pattern in systemic lupus erythematosus (SLE) in 1976 [1], it seemed clear that disease activity, renal involvement and infections played a major role in mortality in the first years after SLE diagnosis, while cardiovascular disease (CVD) was the main cause of death in late disease. However, in recent years, several studies suggested that the relevance of infections as a cause of death in SLE is declining, whereas the burden of CVD and malignancies has progressively increased.
