Assessment of the adjuvant use Niclosamide With Etanercept in Rheumatoid Arthritis

In this randomized double blind placebo-controlled pilot study (Phase I study) we will assess the efficacy and safety of adjuvant use Niclosamide With Etanercept in Rheumatoid Arthritis.

Inclusion Criteria:

• Patients with RA, as defined by the American College of Rheumatology (ACR) 1987 revised criteria or ACR/EULAR 2010,
• Severly Active RA by calculating either DAS28 or SDAI or CDAI.
• Patient selected are those who started etanercept for less than 3months and still active.

Exclusion Criteria:

• Patients on nonsteroidal anti-inflammatory drugs (NSAID) 2 days before entry into this study. or methotrexate (MTX)..
• Patients with hypersensitivity or severe adverse effects to niclosamide .
• Renal impairment.
• Hepatic impairment.
• Pregnancy or a desire to become pregnant.
• Breast feeding.
• Patients with Juvenile RA [16 years old or younger].
• Patients using other conventional disease modifying antirheumatic drugs (DMARDs).
• Patients on steroid.
• Patients with coexistence other connective tissue diseases or hypothyroid disease.
• Patient with mild or inactive RA.