The Effect of Cilostazol on Rheumatoid Arthritis Patients

The goal of this study is to evaluate the effect of cilostazol on Rheumatoid Arthritis patients. It aims to answer the questions of :Will Cilostazol improve the disease severity and quality of life in Rheumatoid arthritis patients?Will Cilostazol decrease the oxidative stress, inflammation and endothelial dysfunction in Rheumatoid arthritis patients?Participants will be randomized into two arms either treatment or control the treatment group will be asked to take Cilostazol 100 mg twice daily in addition to the usual DMARD (Methotrexate , Sulfasalazine , Hydroxychloroquine or Leflunomide), while the control group will be taking the usual DMARDs only.Patients in both arms will be followed-up every 2 weeks through out the 6-month duration of the study.

Inclusion Criteria:Adult patients. (>18 years old).Moderate to high disease activity (DAS28-CRP>3.2).Patients receiving stable cDMARD regimen for at least 3 months before inclusion in the study.Exclusion Criteria:Hypersensitivity to cilostazol.Heart failure.Pregnant and lactating women.Patients with liver impairment (ALT or AST > 3* ULN).Patients with renal impairment (CrCl<60 mL/min).Patients receiving any other antiplatelet or anticoagulant