Study aim: Evaluating effect of nanomicellar silymarin on clinical and immunological indicators in rheumatoid arthritis Design: A randomized, triple-blind, superiority, parallel group trial with three arms (intervention, placebo, control). Sample size: 45 patients (15 per group). Randomization: block randomization (block size 4) using computer-generated random sequence from www.randomization.com with allocation concealment by sequentially numbered, opaque, sealed envelopes. Single center (Ghaem Hospital, Mashhad, Iran). Phase 3. Settings and conduct: Single-center trial in Mashhad. 45 RA patients randomized to 3 groups: silymarin+DMARDs, placebo+DMARDs, DMARDs alone. 8 weeks. Triple-blind (patient, assessor, analyst). Independent person seals allocation. Participants/Inclusion and exclusion criteria: Inclusion: Active RA (ACR/EULAR 2010, score≥6); age 18-60y; disease duration 1-2y; on standard DMARDs (MTX≤10mg/wk + prednisolone≤5mg/d); no biologics. Exclusion: Malignancy; diabetes/CKD/heart failure; pregnancy/breastfeeding; BMI≥35; K/L grade≥4; unwillingness. Intervention groups: Group1 (Intervention): Standard DMARDs + nanomicellar silymarin (SinaLiv) 70mg, 1 cap/day, 8 weeks. Group 2 (Placebo): Standard DMARDs + identical placebo (gelatin capsule with corn starch), 1 cap/day, 8 weeks. Group 3 (Control): Standard DMARDs only. Main outcome variables: Primary outcomes (measured at baseline and week 8): 1. Gene expression changes of 22 immune-related genes including IL-1, IL-4, IL-10, IL-17, IL-18, IL-22, IL-23, TGF-β, IFN-γ, CCL2, CCL5, CXCL8, NLRP3, P2XR, BCMA, APRIL, TACI, BAFF, T-bet, GATA3, ROR-γt, and FOXP3 measured by real-time PCR. 2. Serum levels of CRP, RF, and Anti-CCP. Secondary outcomes (measured at baseline and week 8): 1. DAS28-ESR score (clinical disease activity index). 2. VAS score (pain assessment).