Hello, COPD is a complex disease and reflects airways inflammation not reversed by inhaled corticosteroids and the common cause is smoking. I take it you were still smoking when the TB was diagnosed and when you were on MTX which (if that was the case) was a bad combination. MTX also has lung side effects and classed into MTX-pneumonitis where the typical presenting complaints include fever, shortness of breath (acute) but also long term non-reversible complications of bronchiolitis or restrictive lung disease that may appear like COPD. So please ensure you have seen a Pulmonologist with experience in MTX-lung disease. I hope this was useful.