Cyclophosphamide in Biologic Naïve Rheumatoid Arthritis patients Resistent to Traditional DMARDs

Abstract

heumatoid arthritis (RA) is a systemic and chronic inflammatory disease that has been associated with disability, the existence of comorbidities and decreased life expectancy in which osteoporosis is recognized as a major source of morbidity. Rheumatoid arthritis impose a significant economic burden worldwide, the economic burden of rheumatoid arthritis (RA) is thought to be substantial for both the patients and health services. As a whole, musculoskeletal disorders impose a considerable burden upon society in terms of morbidity, long-term disability and cost. In Egypt the average yearly cost of rheumatoid arthritis patient is statistically undetermined yet, however, the quality of life (QoL) is significantly impaired. The most important factor influence the poor quality of life in Egyptian RA patients is the lack of drug adherence due to financial coast and poor patient education. The poor economic status in our country make it very difficult to cover all rheumatoid arthritis patients health requirements (drugs, doctors visits, hospitalization, laboratory investigations ….etc) under the insurance of the ministry of health. This is especially true when we speak about the biological therapy in the Era of biologics, which in many