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Abstract : Rheumatoid arthritis is represented as a healthcare challenge in the hospital setting due to their stubborn response to therapy and the unavailability of curable agents. The conventional therapy (methotrexate, (MTX) and prednisolone) was claimed to be associated with a high failure rate; therefore the addition of a third agent could be a wise approach to improve patients' daily activity and reduce the inflammation. Therefore, in the present study, we aimed to add hydroxychloroquine as an add-on therapy to conventional therapy and investigate its role in modulating inflammatory markers {Erythrocyte sedimentation rate (ESR), serum C-reactive protein (CRP), Interleukins (serum IL-1β, serum IL-6β), serum Tumor necrosis factor-α (TNF-α)} compared to control group using conventional therapy alone without hydroxychloroquine. The results confirmed that the measured parameters improved in the tested group versus control represented by highly significant improvement in group I in inflammatory markers ESR, CRP, IL-1β, IL-6, and TNF-α as compared with group II and group III, hydroxychloroquine improved inflammatory markers when added as an add on therapy to the conventional therapy of rheumatoid arthritis.