the Effect of Ginkgo Biloba on Rheumatoid Arthritis Patients

this study aims to measure The Effect of Gingko Biloba on the Clinical Outcome of Rheumatoid Arthritis Patients ,the outcomes are hsCRp,calprotectin,DAS-28,HAQ-DI

Inclusion criteria * Adult patients (older than 18 years) - * With moderate to high disease activity defined as DAS-28 score ≥ 3.2 * Patients receiving stable regimen of one or more csDMARDs for the past 6 months Exclusion criteria * Patients with known hypersensitivity to Ginkgo biloba * Patients receiving Ginkgo biloba for any other indications * Patients on biologic DMARDs * Patients with impaired liver functions (liver transaminases level ≥ three times upper normal limits), impaired kidney functions (estimated glomerular filtration rate (eGFR) \< 30 ml/min), * Patients with any of the following comorbidities: congestive heart failure, history of myocardial infarction, severe anemia, active infections, other inflammatory diseases, and malignancies. * Patients with other autoimmune diseases