Clinical Research Directory

Inclusion Criteria: * Patients with active rheumatoid arthritis (not in remission) according to American College of Rheumatology/European League Against Rheumatism (ACR/EULAR) 2010 criteria (13) i.e 28 joints disease activity score (DAS-28) \>2.6. * Age range between 18 and 60 years old. * Patients receive methotrexate; approximately the same doses of non steroidal anti-inflammatory drugs, selective cyclooxygenase-2 inhibitors, acetaminophen, and low dose of oral corticosteroids (Prednisolone \< 15 mg) will be allowed to enroll the trial. * Intravenous, intra-articular or intramuscular corticosteroids; intra articular hyaluronate sodium; biological DMARDs and other conventional DMARDs will not be permitted less than 4 weeks before the first dose of cilostazol. Exclusion Criteria: * Patients with diabetes, congestive heart failure, other heart disease (arrhythmia, hypertension, ischemic heart diseases), severe anemia, bleeding problems, other inflammatory diseases, active infection, other illness except rheumatoid arthritis. * Patients on low doses of aspirin * Patients on anticoagulants. * Patients with renal or hepatic diseases. * Patients receiving oral prednisolone greater than 15 mg/day. * Patients receiving biological DMARDs. * Patients with hypersensitivity to study medications. * Patients using antioxidants . * Pregnant and lactating females.