الفهرس 
List of tablesOnly 14 pages are availabe for public view
 |  | from | 91 |  |  |
| | | from | 91 | | |
Abstract
RA is chronic autoimmune disease with disability impact on daily activities of its patients who are considered about 0.3:1℅ of world wide population, mostly are young age women(Favalli et al., 2018).
In this study we tried to find potential therapy for RA other than (DMARDS) mainly methotrexate which is considered standard drug in RA with multiple sever side effects and toxicity, It was used in our study to be compared with metformin (potential therapy) which has few side effects and beneficial uses mainly in rheumatoid patients with DM.
In this study 50 adult female albino rats weighting about 200 gm body weight were used, classified into 5 groups (G), (n=10) as following:
GI :normal negative control, GII: arthritis model group which was done by subcutaneous injection at right hind limb with 0.4 ml of complete Freund’s adjuvant divided into 3 doses for12 days, one dose every 4 days, GIII: arthritic rats treated with metformin orally as 200mg/kg daily dose for 14 days, GIV: arthritic rats treated with MTX orally as 0.3 mg/kg 2 times per week for 14 days, GV: arthritic rats treated with combined MTX orally as 0.3 mg/kg 2 times per week for 14 days and metformin orally as 200mg/kg daily dose for 14 day.
In this study, the collected data were statistically analyzed using (SPSS) version16.0 database, Comparison between drug-treated groups , arthritic and control groups , parametric data was done by One -Way ANOVA followed by Tukey multiple comparison post hoc test. At P<0.05,the differences were considered to be statistically significant to arthritic control versus normal and treated groups.
This study revealed that the use of 200 mg/kg metformin monotherapy (GIII) in AIA produces statistically insignificant inhibition of disease inflammatory coarse lesser than effect of standard 0.3 mg/kg MTX(GIV) , It was proved by laboratory measurement of serum levels of visfatin, RF and CRP , and also confirmed by both radiological and histopathological findings.
On the other hand, there was statistical significant inhibition and disease improvement by combined metformin and MTX therapy (GV) compared to MTX alone (GIV) also by using laboratory findings, our results revealed significant decrease in visfatin serum levels in (GV) serum samples also with decrease in both Rf and CRP levels.Also our radiological findings revealed significant improvement of rheumatoid arthritic inflammatory changes by X-ray caliberations.
Also, our labolatory, radiological and histopathological results in (GV) showing statistically significant difference from (GII) rats with induced arthritis in both laboratory and radiological findings.
6.2.Conclusion
At the end of this study, it was found that combined metformin and MTX therapy for 2 weeks in AIA statistically significant decrease visfatin serum levels , inhibit rheumatoid inflammatory process and improve disease coarse better than the standard use of MTX therapy.
6.3.Recommendation:
We recommend that rheumatoid patients receiving MTX should receive metformin to decrease disease coarse especially if they suffer also from type II diabetes, also to utalize the benefit of decreasing MTX failure or side effects.
Further studies should be done for detection the actual molecular mechanisms by which how lowering visfatin levels is useful in improvement of rheumatoid disease coarse and inhibition of inflammatory processes and detection of its specific receptors.
On the other hand we recommend further studies on metformin role in RA with another different doses or treatment time periods for detection of the standard metformin drug regimen in dose and duration.