Clinical Research Directory

Inclusion Criteria: * age between 18-60 years old * diagnosed of rheumatoid arthritis according to 2010 American College of Rheumatology/European League Against Rheumatism criteria for at least 6 months * enrolled patients treated with one of more of conventional DMARDs for ≥ 6 months with stable dose for ≥ 1 month before start of the study * active RA despite conventional DMARDs treatment (DAS28 ESR more than or equal 3.2) * patient or legal representative should sign informed consent Exclusion Criteria: * pregnant or lactating female * patients with liver dysfunction (\>1.5x the upper limit of normal value for ALT \& AST) * Patients with kidney dysfunction (serum creatinine more than 1.2 mg/dl) * Patients with any active infection or concurrent malignancy * patients with uncontrolled medical conditions or other rheumatic diseases * patients currently taking drugs that could interact with carnitine like: warfarin