This study will be a randomized controlled parallel study that will be conducted on 66 patients with active rheumatoid arthritis who will be diagnosed with RA according to American College of Rheumatology (ACR)/European League Against Rheumatism (EULAR, 2010). The patients will be recruited from Outpatient Clinic of Rheumatology, Physical Medicine, Rheumatology and Rehabilitation Department, Tanta University Hospital, Tanta, Egypt. The study duration will be 3 months. The patients will be randomized into three groups:
\- Group 1 (control group): will include 22 patients who will receive the conventional therapy for RA for 3 months.
\- Group 2 (diosmin group): will include 22 patients who will receive the conventional therapy for RA plus 1000 mg diosmin once daily for 3 months.
\- Group 3 (rebamipide group): will include 22 patients who will receive the conventional therapy for RA plus 100 mg rebamipide three times daily for 3 months.
Patients with active rheumatoid arthritis (not in remission) according to American College of Rheumatology/European League Against Rheumatism (ACR/EULAR). i.e.,28 joints disease activity score (DAS-28) >2.6.
Both sexes.
Age ranges between 18 and 70 years old.
Patients receiving conventional DMARDs
Pregnant and lactating females.
Patients receiving biological DMARDs or targeted synthetic DMARDs.
Patients with renal and hepatic dysfunction.
Patients with other inflammatory/autoimmune diseases, active infection, or malignancies.