The GRK2 Inhibitor Paroxetine as a Novel Adjunct to Conventional Therapy in Rheumatoid Arthritis Patients
The GRK2 Inhibitor Paroxetine as a Novel Adjunct to Conventional Therapy in Rheumatoid Arthritis Patients
Among three MAPK families, paroxetine was found to be able to decrease the phosphorylation of
 ERK. It was reported that paroxetine attenuates the symptoms of collage induced arthritis
 rats due to its inhibitory effect on T cell activation and infiltration to synovial tissue
 via suppression of ERK pathway. This study aimed to evaluate the therapeutic efficacy of
 paroxetine in rheumatoid arthritis. Paroxetine prevents the joint inflammation which is at
 the very early stage. paroxetine could inhibit GRK2 with selectivity over other GRKs.
 Medications developed for maintaining the immunologic equilibrium. such as GRK2 inhibitors,
 will be the novel trends in RA treatment that could avoid the adverse side effects that are
 common with current treatment options.
Inclusion Criteria:

 • Patients with active rheumatoid arthritis based on DAS28 score. Patients received the
 standard therapy (i.e. one or more conventional DMARDs) for at least three months.

 Exclusion Criteria:

 -  Known hypersensitivity to metformin.

 -  Patients who have a prior diagnosis with diabetes mellitus.

 -  Patients receive metformin for any other indications.

 -  Patients with congestive heart failure.

 -  Patients with a history of myocardial infarction.

 -  Patients with severe anemia.

 -  Patients with active infections or other inflammatory diseases.

 -  Patients receiving biological therapy.

 -  Pregnancy or lactation.

 -  Patients with impaired liver functions.

 -  Patients with impaired kidney functions (serum creatinine concentrations ≥1.5 and ≥1.4
 mg/dL in males and females respectively).

 -  Patients with malignancies.