Tselios K, et al. - Patients with lupus in Ontario, Canada were examined for the evolution of the all-cause, cause-specific and age-specific standardised mortality ratios (SMRs). In the Toronto Lupus Clinic, 1732 patients were followed between 1971 and 2013. Observations revealed a substantial decrease in all-cause SMR from the 1970s (13.5, 95% CI 8.6 to 18.5) to recent years (2.2, 95% CI 1.4 to 3.1). For atherosclerosis, infections and malignancies, they noted similar trends over time. Younger (19–39 years old) patients particularly showed high all-cause age-specific SMR as compared to individuals older than 40 years. Younger patients also showed higher cause-specific SMR, particularly for infections and malignancies.