Mechanisms and Clinical Application of Methotrexate in Rheumatoid Arthritis

Abstract

Rheumatoid arthritis (RA) is a systemic, chronic autoimmune disease that can severely damage the patient's joints and place a great burden on their work and life. Methotrexate (MTX) is currently the firstchoice drug for treating RA. It achieves the therapeutic goal of RA by inhibiting immune responses, promoting the release of adenosine from cells, and inhibiting angiogenesis. However, the efficacy and side effects of MTX vary significantly among individuals, and longterm, high-dose use of MTX can cause serious adverse reactions in some patients, forcing them to discontinue the medication. This article comprehensively analyzes the pathological mechanisms of RA and the molecular and cellular mechanisms of MTX on RA, concluding that the clinical efficacy of MTX and MTX combined with Wind-Dispelling and Dampness-Removing Pain-Relieving Decoction or cannabidiol (CBD) can effectively improve clinical outcomes. It provides a reference for future research on combination therapy with MTX, and the issue of the considerable differences in the clinical efficacy of MTX has not been resolved. Future research can focus on the individual differences in MTX.