Methotrexate in rheumatoid arthritis.

After half a century of use, methotrexate continues to be a cornerstone in the therapy of rheumatoid arthritis. Renewed interest in the 1980s has brought new insights into the mechanisms of action and safety of the drug. The use of combination therapy in rheumatoid arthritis has not masked the value of methotrexate in a competitive market in any way. We review the pharmacodynamics and pharmacokinetics as applicable to its clinical use as an anti-inflammatory and disease-modifying agent here.