The mechanisms of methotrexate’s action in the treatment of inflammatory disease

The introduction of methotrexate for the therapy of rheumatoid arthritis and other forms of inflammatory arthritis has revolutionized the way in which these diseases are now treated. Because methotrexate was introduced empirically for the treatment of inflammatory disease without any specific understanding of a biological basis for its antiinflammatory properties, no improvements on this line of therapy have yet been introduced. A number of recent studies suggest several potential mechanisms of action and new agents developed on the basis of these mechanisms are currently being studied. We will discuss here the biochemical mechanisms by which methotrexate may suppress the inflammation of rheumatoid arthritis.