This study aims to characterize and compare patients of adult-onset RA with patients of elderly-onset RA based on the clinical manifestations, disease activity, severity parameters, and therapeutic features.

Inclusion Criteria:

• 1) Patients fulfill the 2010 American College of Rheumatology/ European League Against Rheumatism Classification Criteria for Rheumatoid Arthritis [7] 2) Age of disease onset above 16 years old. 3) patient is cooperative and can answer questions. 4) Patients who are able and willing to give written informed consent.

Exclusion Criteria:

• 1) Other rheumatologic or collagen diseases. 2) Age below 16 years. 3) Active infection 4) Pregnancy 5) Malignancy 6) Uncooperative patients. 7) Patient not able and willing to give written informed consent.

Rheumatoid Arthritis patients

All patients will be subjected to the following:

1. Full medical history from the patients, including Demographic data (Age, Sex, Marital status, Occupation, Residence), duration of disease, Comorbidities, and the treatments that patients receive.

2. Full clinical examination and assessment including:

   1. General examination and Complete rheumatological examination.
   2. Application of American College of Rheumatology/ European League Against Rheumatism Classification Criteria for Rheumatoid Arthritis, on all RA patients.

3. Laboratory investigations: (Blood sample will be collected into 5ml tubes containing Ethylenediaminetetraacetic acid (EDTA) ).

   • complete blood count (CBC) (done on fully automatic BC 21S hematology analyzer).
   • erythrocyte sedimentation rate (ESR).
   • C- reactive protein (CRP) (using Enzyme-linked immunosorbent assay (ELISA)).
   • rheumatoid factor (RF) (using ELISA).
   • anti-cyclic citrullinated peptide antibody (ACCP Ab) (using ELISA).

4. Disease activity assessm

Beginning 3 months and ending 3 years after the publication of results")

on clinical trials website