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Diagnostic Criteria for Rheumatoid Cachexia

Cachexia in RA (rheumatoid cachexia, RC), is mainly characterized by loss of muscle mass, in particular appendicular lean mass (ALM), and associated with accumulated fat mass (FM), situated mainly in the trunk area, indicating a shift towards the development of abdominal obesity. The loss of body cell mass (BCM) consists of an important issue of concern for patients with RA. BCM consists primarily of muscle and visceral mass (erythrocytes, serum proteins, lymphocytes, etc.), and is the part of the body with the greatest metabolic activity (95% of the total activity), determining protein requirements, energy expenditure, and the metabolic response to stress.

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The 2010 American College of Rheumatology/European League Against Rheumatism classification Criteria for Rheumatoid Arthritis (RA)

Rheumatoid arthritis (RA) is a chronic inflammatory disease characterized by joint swelling, joint tenderness, and destruction of synovial joints, leading to severe disability and premature mortality. Given the presence of autoantibodies, such as rheumatoid factor (RF) and anti–citrullinated protein antibody (ACPA) (tested as anti–cyclic citrullinated peptide [anti-CCP]), which can precede the clinical manifestation of RA by many years, RA is considered an autoimmune disease.
A joint working group of the ACR and the European League Against Rheumatism (EULAR) was therefore formed to develop a new approach for classification of RA.
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The 2008 ACR Recommendations for Rheumatoid Arthritis Treatments

  • Initiating treatment with methotrexate or Arava (leflunomide) was recommended for most rheumatoid arthritis patients.
  • Methotrexate plus Plaquenil (hydroxychloroquine) was recommended for rheumatoid arthritis patients with moderate to high disease activity.

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