The Effect of Cilostazol on Rheumatoid Arthritis Patients

Rheumatoid Arthritis (RA) is an autoimmune disease affecting joints. It usually affectsfemales more. The available treatment aims to slow down disease progression and controlthe disease symptoms. Treatment is classified into either the conventional DMARDs(Methotrexate , Sulfasalazine , Hydroxychloroquine or Leflunomide) or Biological DMARDssuch as an Anti‐TNF alpha ( Certolizumab, Infliximab , Etanercept or Golimumab) ornon‐TNF biologics (Rituximab, Abatacept or Tocilizumab). Both classes have theirdrawbacks. The conventional DMARDs is not effective for many patients and the biologicalDMARDs have a high cost making their use limited to patients with medical insurance orpatients who can afford it, thus making it necessary to find new medications which canimprove the outcomes in patients with RA.Cilostazol is an antiplatelet agent used mainly for intermittent Claudication. Recentlymany preclinical trials have shown efficacy of cilostazol in RA via it'santi‐inflammatory action. it also decreases the oxidative stress which is high in ٌRApatients.Patients will be randomized into two arms , one which is treatment and the other iscontrol the treatment group will be asked to take Cilostazol 100 mg twice daily inaddition to the usual DMARD (Methotrexate , Sulfasalazine , Hydroxychloroquine orLeflunomide), 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 durationof the study.