Inclusion Criteria:  patients with active rheumatoid arthritis (disease activity score-28 joints: DAS-28 > 3.2) based on the 2010 American College of Rheumatology (ACR) criteria16 were recruited.  rheumatoid Patients who received the standard therapy (i.e. one or more conventional DMARDs) for at least three months.  Exclusion Criteria:  History of biological DMARDS. History of gastrointestinal surgery, GI ulceration,GI bleeding, gastroesophageal reflux disease Intolerance or allergy to rebamibide or methotrexate Smoking or alcohol abuse Any changes in using medication (changing the dosage or type of medicines) Receive hormone replacement therapy, warfarin, and other anticoagulants