Methotrexate has been used for RA since the late 80’s.  It is the cornerstone for RA treatment and considered to have an impressive safety record. Methotrexate is classed as  a DMARD, Disease Modifying Anti-Rheumatic Drug. It decreases pain and swelling. It can lessen joint damage and consequently long-term disability. Methotrexate is taken once a week usually in pill form. The injectable form is reserved for those who don’t tolerate the pill or to extend the effectiveness of the drug. Self-injection is not hard to learn for those who need it. It can be easy to do with a prefilled  auto-injector that comes in a variety of doses. The auto-injector is useful for children with JIA, too. Methotrexate is frequently paired with other DMARD’s. Plaquenil, an anti-malarial drug is often used. Sometimes sulfasalazine is added, too. Drugs used in combination with methotrexate are usually more effective. Methotrexate is also paired with the biologics including Orencia and Rituxan. The biologics become more effective when teamed with methotrexate. RA can continue on its destructive path when there are no obvious symptoms. It’s reassuring to …